DEAR DR. DONOHUE: I have an embarrassing problem, and my doctor says nothing can be done about it. I no longer can dependably control my bowel movements and often have accidents. I have had to eliminate all social contacts and have become a recluse. Is my doctor right? Can’t anything be done? – V.K.

ANSWER: Your doctor isn’t right. Many things can be done.

Bowel control requires the proper functioning of nerves and muscles. The muscles are the anal sphincters (SFINK-turs) – two bands of muscle that encircle the anus to keep it closed until a person voluntarily relaxes them to empty the rectum. Another muscle, which attaches to the pubic bone – the puborectalis – contributes to control.

Injury stemming from childbirth, trauma and age are some of the things that weaken the anal sphincters. There are a number of surgical procedures that might be able to correct sphincter injury.

Loss of the sensation of rectal fullness and other nerve problems also can produce fecal incontinence. A nerve stimulator, a device that sends electrical impulses to control the sphincter muscles, often allows a person to regain control.

If the problem is impairment of both muscle sphincter and nerve, and function is not completely gone but weakened, then firming soft to liquid stools can sometimes bring back continence. That can be effected by decreasing dietary fiber and taking a medicine, such as Imodium, to solidify the stool.

In instances that resist all treatment, a colostomy can be considered. It’s an outlet for the colon created in the abdominal wall. An attached pouch catches undigested food.

I’ve given you only a sample of possible treatments. You need to talk with a proctologist or a gastroenterologist.

READERS: Fibromyalgia is a condition that bewilders many and disrupts the lives of those who have it. The booklet on that topic explains the illness and its treatments. Readers can order it by writing: Dr. Donohue – No. 305, 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: Please address the practice of many college students “borrowing” drugs like Adderall and Concerta from other students to keep them awake. They believe that these drugs are harmless because they are prescription medicines. Please advise them of the dangers of doing this. – F.G.

ANSWER: Taking someone else’s medicine is the depth of stupidity. People take medicines to control a disorder that they happen, unfortunately, to have. The side effects of the medicine are justified by the seriousness of the condition being treated. No medicine comes without side effects.

Adderall is an amphetamine mixture. Concerta is an extended-release form of methylphenidate. Both drugs are mild brain stimulants, and both are used in treating attention deficit disorder as well as other conditions. People with heart ailments should take such drugs only after a doctor exam. College students who might not know they have a heart problem and take these drugs could get into trouble. Both drugs can upset control of bipolar disorder, something that college students could have and not know it. Prescription medicines are safe only for those for whom they have been prescribed.

DEAR DR. DONOHUE: I’ve been trying to increase my fiber intake. I have found three different lists on the Internet for foods’ fiber content, and they don’t agree with one another. It becomes disheartening. What is an accurate source of information for fiber? – B.O.

ANSWER: Bowes and Church’s Food Values of Portions Commonly Used, edited by Jean A.T. Pennington and Judith Spungen Douglass is a good source for such information. The publisher is Lippincott, Williams and Wilkins. Go to a public library, check it out and copy the information you want. It’s an expensive book.

DEAR DR. DONOHUE: I dread going to bed. I can’t get to sleep because I hear my heart beating loudly in my ear. It drives me crazy, and most of the night I am wide awake. My husband told me to wear earplugs. I did, and they didn’t help. They made the sound louder. What can I do to get rid of the noise? – M.S.

ANSWER: You have pulsatile tinnitus, the sound of your own heart beating – usually in one ear, but it can sometimes be heard in both. It’s a condition that affects many, particularly older people.

Hardening of the arteries in structures near the ear or even in the neck can transmit the heartbeat to the ear, and a person becomes quite aware that the heart is beating 60 or more times every minute. The noise is accentuated at night, when everything else is still.

High blood pressure is another cause. So are some rare tumors in the region of the ear.

It’s not necessary to upset you with a list of grim illnesses that have been implicated as causes, and I am not telling you to rush to your doctor. But I do want you to tell him or her about this at your next visit so that a look at possible causes is taken.

In the meantime, sleep on two pillows. Sometimes a change in head position can eliminate or soften the noise. Don’t take anything with caffeine in it from noon on, and it is best to stay completely away from alcohol.

If it won’t disturb your husband, tune a bedside radio to a station that plays music you like, but keep the volume on low. This sound can drown out the tinnitus noise. If the radio keeps your husband awake, invest in earphones equipped with a built-in radio.

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