DEAR DR. DONOHUE: My 68-year-old wife was diagnosed with irritable bowel syndrome accompanied by belching, flatulence and abdominal distention. The distention mimics a pregnant abdomen. Is distention a symptom of IBS, or is something else going on? – F.C.

ANSWER: Irritable bowel syndrome is one of the most common digestive-tract problems. Distinguishing signs and symptoms include: stomach pain, usually lessened with the passage of stool; increased frequency of bowel movements to the point of diarrhea or decreased frequency to the point of constipation, or alternation between the two; and a change in the appearance of the stool, from soft to hard, for example. Abdominal distention and bloating are other symptoms, but one or more of the first three should also be present.

The intestinal tract has its own set of muscles that keep food moving through it. Irritable bowel syndrome might result from out-of-sync contraction of those muscles. Or it might have its basis in a change in the usual bacterial population of the digestive tract.

Since gas, distention and bloating are such problems for your wife, she should cut back on the amount of fiber in her diet. She should reduce raw fruits and vegetables. She should cut back on whole-grain products. This flies in the face of everything most of us are told to do. She should go easy on caffeinated or carbonated beverages. Milk, eggs, wheat, cheddar cheese, rice, potatoes and soybeans could be troublesome for her. The best way for her to find which foods cause her most trouble is to keep a diet diary and eliminate any food that aggravates her symptoms. This isn’t the diet for all with irritable bowel syndrome. It’s one for your wife, with her unique problems.

Your wife is a bit old to come down with IBS. It usually appears before age 50, and often in the 20s. Other illnesses should be considered, such things as colon cancer, stomach cancer, ovarian cancer and celiac disease.

DEAR DR. DONOHUE: My husband and I have been trying to start a family for three years. I have been examined by two gynecologists and have had many tests, including tests showing that my tubes are open. The second doctor said my husband should be tested and that he would make arrangements for him. My husband refuses. He says all infertility comes from the woman. Is that so? – L.H.

ANSWER: That’s not so. Men account for half of fertility problems. Since you have undergone extensive testing and examinations, the chances are quite high that it’s your husband who needs an investigation. That doesn’t mean he could never father a child; he might have a correctible problem. His and your wishes for a family aren’t likely to be fulfilled unless he undergoes an exam and has tests.

DEAR DR. DONOHUE. I have osteoarthritis and osteoporosis. I am 92. What kind of over-the-counter pill can I take to relieve the pain in my hips? My pharmacist and doctor are too busy to answer my question. – G.P.

ANSWER: Try Tylenol (acetaminophen). It’s a good medicine for relief of osteoarthritis pain. It’s gentle on the stomach too. If you plan to take it every day, let your busy doctor know what you’re doing.

DEAR DR. DONOHUE: I was only 35 when I had my ovaries and uterus removed. My doctor, who has since died, put me on estrogen, and I am still taking it. I am now 42. Is this too long to be on estrogen? I don’t want to get breast cancer. – J.P.

ANSWER: The ovaries are a woman’s primary source of estrogen. Without them, a woman enters menopause immediately. At such a young age, that would doom you to osteoporosis. Your doctor put you on estrogen to prevent osteoporosis and all the other things that come with menopause.

You still have not reached the age when most women enter menopause – 51. Your current doctor must be going along with your former doctor’s plan. He or she is writing you prescriptions for estrogen, correct? Staying on estrogen until the biological age when menopause is supposed to occur is not putting you in danger of coming down with breast cancer.

DEAR DR. DONOHUE: I have read articles on erectile dysfunction saying that diuretics could be the cause. I am engaged to a wonderful man with ED who refuses to talk to his doctor about it. Is a medicine change possibly all he needs? If I marry a man who is not interested in an intimate relationship, I will become resentful. – Anon.

ANSWER: Some diuretics can sometimes make some men develop ED. Your fiance can find out by asking his doctor for a different diuretic if his is on the list of those with ED as a possible side effect.

If his problem isn’t due to the diuretic, he should find out what the cause is. If it can be eliminated, that’s the cure. If it can’t, there are medicines like Viagra, Cialis or Levitra.

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

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