DEAR DR. DONOHUE: Three weeks ago, I had the most awful stomach pain I have ever had. Then I started to throw up. My wife called 911, and they took me to the nearest hospital. The emergency-room doctor thought I had pancreatitis and got the ball rolling. I did have it. I stayed in the hospital for three days. I’m fine now.

When my boss learned my diagnosis, he assumed I was an alcoholic. I can’t convince him otherwise. He was an alcoholic and is on a mission to convert all alcoholics. He wants me to attend Alcoholics Anonymous meetings with him. I don’t want to offend him, but it would be silly for me to go. Can you help me out? — J.J.

ANSWER: The pancreas has two separate functions. It makes digestive enzymes that break down carbohydrates, proteins and fats so that they can be absorbed and used by the body. Its second function is the production of insulin for regulation of blood sugar.

Inflammation of the pancreas — pancreatitis — occurs for many reasons. In Canada and the United States, the two most common causes are gallstones and alcohol. Small gallstones, less than 2 millimeters in diameter, can plug the duct that drains digestive enzymes out of the gland. The gallbladder and pancreas share a common duct. Those obstructed enzymes begin to digest the pancreas. That causes terrible upper-abdominal pain that often bores through to the back. Nausea and vomiting are part of the picture.

When alcohol is the cause, its consumption must be heavy and prolonged, at least five years.

Other causes include viral infections of the gland. High blood triglycerides (fats) also inflame the pancreas. They usually have to be higher than 500 mg/dL (5.65 mmol/L), and often are twice that level. Autoimmune inflammation is another cause. In this case, the body has turned on the pancreas, thinking it is a dangerous enemy. And — this will astound your boss — for up to 20 percent of pancreatitis patients, no cause is found.

Your boss is a well-meaning person, but your attendance at AA meetings does no one any good.

TO READERS: The facts on chronic fatigue syndrome are told in the booklet with that name. Readers can obtain a copy by writing: Dr. Donohue — No. 304, 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 a weight problem and have had it all my life. A friend tells me I can take off pounds quickly by exercising in a rubber suit. She says she lost 20 pounds in a month by doing so. I’m considering trying it. What are your thoughts? — B.R.

ANSWER: I don’t disbelieve your friend, but I do have a few doubts.

Exercising in such a suit makes you perspire heavily. Perspiration happens for a reason: The body is trying to cool itself through the evaporation of sweat.

This can be a good way to dehydrate yourself. Dehydration can be lethal. I have no personal knowledge of anyone dying from using such a suit, but I have read about some athletes who have died following a strict exercise regimen that included dieting, wearing a rubberized suit and limiting their fluid intake.

Exercise is a good idea; the suit isn’t. I have to add one discouraging note. Losing a pound of fat through exercise alone requires lots of exercise. Cutting calories has to be part of your program.

DEAR DR. DONOHUE: My next-door neighbor has a teenage daughter who wheezes and struggles to breathe when she’s upset. The attacks last quite a while. She never talks about it, and neither does her mother. Do you think this is normal? — L.Y.

ANSWER: I don’t. They could be asthma attacks. Stress can trigger asthma. She needs to see her doctor.

If your neighbor might be upset that you are nosing into affairs you shouldn’t, tell her I am the one who is doing the nosing.

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 32853-6

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