DEAR DR. DONOHUE: I am in my 80s and have a problem. I had a car accident three years ago. Since then, I pass gas most of the time, and I can’t hold it in. I am very embarrassed to go out of the house.

Please tell me what causes it, or what I can do to prevent it. — Anon.

ANSWER: Flatulence, the passage of rectal gas, occurs 10 to 20 times a day for almost everyone. Some of that gas comes from swallowed air. Eat food slowly to lessen the chances of getting air into the digestive tract. Most of the gas is due to the fermentation of foods by bacteria in the colon. A few illnesses are associated with excessive flatulence — celiac disease and pancreatic insufficiency being two examples. The pancreas supplies enzymes to digest food. Without those enzymes, bacteria digest the food. I can’t implicate the car accident as a cause.

Make a few adjustments to your diet. I’ll name foods that are the most troublesome. Don’t eliminate all of them at once. Pick two or three, and keep them out of your diet for two weeks. If you don’t note a reduction in gas by two weeks, start eating those foods again and eliminate three others. Milk products, including cheeses and ice cream, fruits and carbonated beverages are three foodstuffs to eliminate in trial one. After two weeks, if there’s no whiff of change, go back to eating those foods, and stop eating beans, peas and pastas. If a third trial is necessary, get rid of cabbage, broccoli and cauliflower. Brussels sprouts and lentils are other gas producers. If you note that you are gassy after particular foods, then erase them from your diet.

Have you tried Gas-X, Phazyme or Beano? Do so.

If all this comes to naught, other options are available. Flat-D Innovations, Inc. makes a pad that is inserted into the underwear to absorb gas. The toll-free number is 866-354-0056 and their website is www.flat-d.com. The Under-Tec Corporation makes different products that soak up gas. Its toll-free number is 888-433-5913 and its website is www.under-tec.com. If you have no computer, surely a friend or relative does. You can see pictures of these products online.

DEAR DR. DONOHUE: My mother had severe abdominal pain. I called an ambulance. When the paramedics arrived, she started gasping and closed her eyes. They said she had a seizure and went into cardiac arrest. In the emergency room, the doctor said she probably had a ruptured aortic aneurysm. The death certificate said she had a myocardial infarct (heart attack). Which do you think it was? — D.J.

ANSWER: If an autopsy was done, it will provide the definitive answer. Any tests done in the ER also would help make a diagnosis. The severe abdominal pain suggests an aneurysm. The pain of a heart attack can be felt in many places, not just the chest. It can be centered in the abdomen. I have to go with the death certificate. The doctor who signed it must have had evidence for the heart attack cause. You might be able to contact him about his reasons for believing that.

The booklet on heart attacks explains their cause and their treatments. Readers can order a copy by writing: Dr. Donohue — No. 102, 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 what the doctor calls a Charcot (shar-COE) joint in my foot. Just by stepping on the foot when getting out of bed, I broke two bones. I’ve been a diabetic for 45 years. Information is deeply appreciated. — L.M.

ANSWER: A Charcot joint is one that has been damaged and deformed because the nerves to that joint no longer bring pain signals to the brain. The foot, therefore, doesn’t make adjustments that it would make if it felt pain. Repeated trauma to the joint and bones promotes fractures and distortion of the joint and bones. Diabetes is usually the cause of the nerve malfunction. No medicine restores the foot to health. Braces and splints, however, stabilize the foot and make it more functional.

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.