DEAR DR. DONOHUE: I have had Sjogren’s syndrome for more than five years. I really never have had much of a problem with it other than dry eyes and dry mouth.

Recently I have had pain in my shoulders, arms, wrists and fingers. The doctor says my Sjogren’s is “off the chart.” He told me to take Tylenol Extra Strength. I need stronger pain medicine.

The doctor says there hasn’t been much research on Sjogren’s, so I have no idea what kind of treatment I should be getting. I have so much pain that I am unable to use my hands at all. Can you give me any help? I was also diagnosed with lymphoma. – J.D.

ANSWER: Dry eyes and dry mouth are the classic Sjogren’s (SHOW-grins) syndrome symptoms due to an immune-system attack on the tear and salivary glands. There are medicines for both, but neither seems to be a problem for you.

Sjogren’s isn’t limited to those two problems. It can bring on joint pains, swollen lymph nodes, lung involvement, inflamed blood vessels, kidney and liver trouble, neuropathy and muscle inflammation.

About 2.5 percent of Sjogren’s patients come down with a lymphoma, cancer of lymph nodes.

Yours is a complicated case of Sjogren’s that needs the direction of experts – a rheumatologist for whom Sjogren’s is part of his or her area of expertise and an oncologist for the lymphoma cancer.

Furthermore, other joint diseases – rheumatoid arthritis and lupus – can coexist with Sjogren’s, and either could be the reason for your pain.

Those illnesses call for the attention of a rheumatologist specialist.

I don’t want to suggest any treatment for you other than to get hold of two specialists in the fields I mentioned. You need trained experts.

Contact the Sjogren’s Syndrome Foundation.

It’s an organization devoted to people with the condition, and you’ll find the foundation’s personnel eager to provide you with information and help. The foundation’s toll-free number is 800-475-6473, and its Web site is www.sjogrens.org.

DEAR DR. DONOHUE: I am an insulin-dependent diabetic and have been for 40 years. I developed diabetes at age 8.

I would like your opinion on a kidney-pancreas transplant. I am on the list for this procedure. I was told I am a perfect patient for the operation. Can a person live a normal life, free of diabetes, after this procedure? – L.Y.

ANSWER: Surgeons have successfully transplanted a kidney with a pancreas for selected type 1 diabetes patients since 1966, so this is not experimental surgery. It frees a diabetic from having to use insulin and from undergoing dialysis treatments for failing kidneys.

I would say life after such a transplant is normal. You will have to take anti-rejection medicines, like all transplant patients, but life will be much easier for you than it currently is.

If I were in your shoes, I would jump at the chance to have the operation.

DEAR DR. DONOHUE: I just read your piece on loss of bowel control.

For three and a half years, I was diagnosed as having inflammatory bowel disease, but the doctor was vague about calling it either Crohn’s disease or ulcerative colitis. I had to use the bathroom 10 to 15 times a day.

I did not fit the picture of a person with IBD, since I gained weight. I got a second opinion and was told I had irritable bowel syndrome. I took Lomotil and it helped, but I still had accidents. I mentioned to the doctor that I had had my gallbladder removed, and he put me on Colestid.

I got my life back. Today I lead a relatively active life, eat salads and fruits and have my diabetes under control.

People should know this side effect of gallbladder surgery. – S.L.

ANSWER: The gallbladder stores bile and shoots it into the intestine after a fatty meal to aid in digestion.

Without a gallbladder, bile drips into the intestine more or less constantly, and most people get along quite well with that arrangement.

For a few, however, the constant drip of bile irritates the intestine and brings on diarrhea.

Colestid and another medicine, Questran, absorb bile, and either often ends bile-induced diarrhea.

I’m sorry it took so long for you to get a proper diagnosis, but I’m happy your life has been restored.

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