DEAR DR. ROACH: I have been diagnosed with irritable bowel syndrome. However, the only time I am affected with multiple bowel movements, cramps and loose, watery stools is after breakfast and lunch. Do you have any ideas of why this could happen at these two meals only? I did not have any problems until after the removal of my gallbladder.

I am afraid to travel now because of my condition. What is your opinion regarding being affected with IBS only after breakfast and lunch, and can you provide more information about possible treatment or cures? — R.G.

ANSWER: Irritable bowel syndrome is a common condition that encompasses one or more of the following characteristics: abdominal discomfort, usually cramping or fullness, often relieved by bowel movements; stool changes, constipation, loose bowel movements or alternating between. It affects more women than men.

IBS can be debilitating, and a large number of people with this condition limit their social activities because of symptoms or fear of symptoms. There is no cure for IBS, but most people can find relief with treatment. Treatment includes dietary changes, medications and stress management. IBS does not cause permanent damage to the intestines and does not increase cancer risk.

Dietary changes are tricky, because what works for one person may make someone else worse. For example, fiber helps many people with constipation symptoms, but may worsen people who have fullness and bloating. Broccoli and onions are frequent triggers, as is caffeine. Keeping a food diary and a symptom diary can be helpful in tracking down whether foods are a big trigger.

In your case, I would concern yourself with the foods you’ve eaten during breakfast and lunch, especially caffeine. However, since stress can make a big impact on symptoms, I wonder if work stress may be part of your issue. Also, I have had a few patients who developed IBS symptoms after gallbladder removal, and the use of the prescription medication cholestyramine, which binds bile acids (formerly kept in the now-removed gallbladder), occasionally has been life-changing.

Having a talk with an expert in this, usually a gastroenterologist, can be very helpful.

TO READERS: The booklet on colon cancer provides useful information on the causes and cures of this common malady. Readers can obtain a copy by writing: Dr. Roach — No. 505, 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. ROACH: In the past couple of years, I have experienced a small degree of hair loss during the winter, and wondered what it portends for the future. I find, however, that growth restores again during the rest of the year. I have read that this may be due to the flu vaccine. Can you expand on this matter? — A.R.

ANSWER: There have been a few cases of documented hair loss after vaccination, usually the hepatitis B vaccine. However, there have been even more cases associating with influenza (the flu) and hair loss.

In my opinion, the likelihood that this is due to vaccines is very small, and the overall benefit of influenza vaccine is greater than the risks. There are other reasons people have published for winter hair loss, including dryness, hat wearing and hormonal changes. It’s not clear what causes it, but don’t skip the flu vaccine due to fears of hair loss.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.

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