DEAR DR. DONOHUE: My 83-year-old friend had his gallbladder taken out about four months ago. He has suffered from gas and diarrhea ever since, even though he watches the fat content of his foods. He takes Beano, and that helps some. Can you give him other ways to solve his problem? – B.P.

ANSWER: Will you let me concentrate on the diarrhea part? I just did gas two days ago.

The gallbladder is a storage tank for bile made by the liver. When we eat fatty foods, the gallbladder contracts and shoots a jet of bile into the intestine to aid in fat digestion.

Without a gallbladder, bile drips into the intestine constantly. Some of it travels to the colon, where it irritates the colon lining and leads to diarrhea. This doesn’t happen to everyone without a gallbladder, but it happens to enough that it is an often-mentioned postoperative result of gallbladder surgery. For some, the diarrhea lessens with time.

It’s good your friend watches the amount of fatty foods he eats. He should limit fried foods, too, and spicy foods. He should cut way back on alcohol and caffeine.

If diet changes don’t solve his diarrhea problem, then medicines can help. Imodium, a commonly used antidiarrhea medicine, can often control bile-induced diarrhea. Questran and WelChol, two cholesterol medicines, bind bile, and that can stop watery stools. Questran is the more commonly used medicine for this condition. The antacid Amphojel is another way to stop bile diarrhea.

DEAR DR. DONOHUE: I have gallbladder attacks without having gallstones. Is that possible? – R.W.

ANSWER: Yes, it’s possible. One condition that produces attacks of gallbladder pain is biliary dyskinesia. The gallbladder doesn’t empty its bile content, and the ever-full bladder causes attacks or pain on the right, upper side of the abdomen. Sometimes people become nauseated and vomit just as they do with gallstone pain. Fried foods or fatty foods usually precipitate an episode.

The condition can be proved with a special kind of scan, a radioactive technetium HIDA scan. After injecting the material, the doctor gives the patient CCK, a substance that makes the gallbladder contract. Pictures of the gallbladder are taken in half an hour. If less than 30 percent of the bile has been emptied from the gallbladder, then the diagnosis of abnormal gallbladder contraction is made with great certainty. The usual treatment is gallbladder removal.

DEAR DR. DONOHUE: A while back you discussed the differences between osteoarthritis and rheumatoid arthritis. You mentioned that rheumatoid arthritis could affect the eyes. Would you discuss that in greater detail? I have had lots of trouble with my eyes since being diagnosed with rheumatoid arthritis in 1994. – J.O.

ANSWER: Rheumatoid arthritis is a “systemic” illness, and that indicates it affects many body organs and tissues in addition to joints. With rheumatoid arthritis, nodules can form under the skin, especially at the elbows and around the Achilles’ tendons of the heels. It frequently inflames blood vessels. It can fill the coverings of the heart and lungs with fluid.

Eye involvement happens to less than 1 percent of those with rheumatoid arthritis. The sclera becomes inflamed. Part of the sclera is the white part of the eyes. The eyes redden and are painful. Rheumatoid arthritis can also bring on Sjogren’s syndrome – a dryness and gritty sensation of the eyes. Both conditions are treatable.

The booklet on arthritis discusses its many forms and treatments. Readers can obtain a copy by writing: Dr. Donohue – No. 301, P.O. Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Can you recommend help for an alcoholic woman? My daughter-in-law drinks to excess, and my son is unsure where to turn. – J.K.

ANSWER: Alcoholism strikes women as well as men. Alcoholics Anonymous welcomes both sexes to its programs. If that is not to your daughter-in-law’s liking, the family doctor can recommend a therapist for her.

DEAR DR. DONOHUE: I work out about four times a week. Two or three hours after my workout, I have a migraine headache. Why does this happen? I don’t take any medicines. – L.M.

ANSWER: Are you sure your headache is a migraine? Migraines are one-sided headaches that are usually accompanied by nausea and sensitivity to light and sound. They make people seek a quiet, dark place to lie down.

What your headaches might be are exertional headaches, which come on during exercise or after it. During exercise, blood flow to the scalp and head increases. The increased volume of blood puts traction on blood vessels, which can bring on a headache. If you have ever had a head injury, the injury makes a person more susceptible to exertional headaches.

If the headache is the exertional variety, it’s usually safe to take a Tylenol before exercise to prevent it.

If, indeed, the headache is a migraine, there are prescription medicines that can be taken to prevent migraines.

Just to play it safe, ask your doctor about this. Headaches that suddenly begin in situations that never caused them previously could be a sign of more serious problems. They should not be dismissed as innocent.

The headache booklet deals with all headache varieties and their treatment. People can order a copy by writing: Dr. Donohue – No. 901, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.