DEAR DR. DONOHUE: I wonder if you could give me information on irritable bowel syndrome. I am 67 and have struggled with it for years. What diet is most effective for it? I believe the nervous system plays a part in it. Do you? There are times when I have no control, and it is very upsetting. – M.K.

ANSWER: Irritable bowel syndrome is one of the most common digestive-tract disorders. People with it describe their stomach pain in various ways – crampy, coming and going, constant, on the right, on the left or in the middle of the stomach. For most, the pain is relieved with a bowel movement. A change in bowel habits is a second important indication of IBS. The change can be diarrhea, constipation or diarrhea alternating with constipation.

The cause hasn’t been completely explained. It might be a disruption of the coordinated contraction of the intestinal muscles. Or it might reflect heightened sensitivity of the digestive tract to the tract’s muscle contractions or to its distention with food or gas. Anxiety, if that’s what you mean by nerves, can aggravate symptoms, and nerve malfunction might have a hand in it. The best diet for someone with IBS is a diet devised by the person who notes what foods cause the most problems – in other words, you. It is useful for patients to eliminate dairy products for a week or two to see if they make matters worse. The inability to digest milk sugar (lactose intolerance) often goes hand in hand with IBS. Foods that are notorious gas producers exacerbate symptoms: beans, onions, carrots, bananas, brussels sprouts, bagels and pretzels.

Levsin and Anaspaz can calm spasms of the intestinal muscles. Imodium frequently controls diarrhea, which apparently is a problem for you. Lotronex is marketed for women with severe, diarrhea-predominant IBS. For a few users, it has caused serious side effects. Your doctor and you can decide its appropriateness in your case.

FOR READERS: Many have written about the signs and symptoms of fibromyalgia. The booklet on that disorder discusses it in length. To obtain a copy, write: Dr. Donohue – No. 305, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I have white spots and lines on my fingernails. What causes them? Is it a vitamin deficiency? – D.

ANSWER: Those spots and lines indicate a brief pause in nail production. They’re not a sign of vitamin deficiency. Trauma to the nail can do this, and the trauma can be so slight that it never registers on your consciousness. It takes six months for a fingernail to grow from base to tip. Your spots and lines are halfway up the nail, so they should be gone in another three months. Thanks for the photo. It helped me.

DEAR DR. DONOHUE: I have been told I have leukopenia, and was also told not to worry: “We’ll watch it.” I also have type 2 diabetes and take Avandia and glipizide for that. I take Crestor for my cholesterol. Could any of this be related to leukopenia? – B.S.

ANSWER: “Leuko” is Greek for “white.” “Penia” indicates a deficiency. Leukopenia is, therefore, a lower-than-normal number of white blood cells. Of your medicines, Avandia might cause a slight decrease in white blood cells. Diabetes doesn’t ordinarily lower the white blood count. White blood cells are one of the body’s defenses against infections. You haven’t had an unusual number of infections, have you? Your count is not so low that it is a danger to your health. You can believe your doctor. Watching the count is about all that needs to be done right now.

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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