Q: I cannot talk to anyone about this embarrassing problem, not even my doctor. Some days I experience bouts of flatulence that are so smelly, I cannot bear to go out in public.
My niece is getting married next month, and I would dearly like to go to the wedding. But I am so afraid that I would spoil the event, for me and those around me, that I am considering bowing out. Is there anything I can do to control the odor?
A: Your doctor has surely heard far more embarrassing questions than yours. Please discuss this with your physician to rule out any serious digestive problems.
One possible solution is bismuth subsalicylate, found in Pepto-Bismol. Research published in the journal Gastroenterology (Vol. 114, 1998) demonstrated that this simple remedy reduced gas odor up to 95 percent. You shouldn't use Pepto-Bismol daily, but it could be helpful for a special event like your niece's wedding.
Q: I will be traveling to Kenya and will need to take anti-malaria medication. I've heard conflicting information regarding side effects of Lariam. Some authorities state that this medicine has a low level of side effects. But I have also heard testimonials from people who have had panic attacks after taking this drug. Do you have any information on this? Is there any alternative?
A: Lariam (mefloquine) has made headlines because the Army is investigating the drug's possible connection to a series of domestic murders and suicides at Fort Bragg, N.C. The soldiers had taken Lariam to prevent malaria while on active duty.
Peace Corps volunteers have complained for years that Lariam causes weird psychological side effects. Medical experts acknowledge that it might cause confusion, nightmares, hallucinations, aggression, agitation, anxiety, depression or psychosis.
Public-health officials support the value of Lariam for people traveling to areas with resistant malaria. However, Malarone and doxycycline are effective alternatives.
Q: If I don't get a decent night's sleep, it leaves me irritable and makes it hard to focus. I have a lot of responsibility and cannot afford to be sluggish or groggy during the day.
When I am especially keyed up and afraid I won't be able to sleep, I take Tylenol PM. But I worry about taking it every night for fear it will lose its effectiveness.
I've seen ads on TV for a drug called Ambien. Would it be compatible with my other medicines? I take Claritin-D, Toprol and Zoloft.
A: Before you ask your doctor about Ambien, you might want to discuss your other medications. They could all be contributing to your sleeping problems. The "D" in many allergy medicines is a decongestant that can be stimulating. Beta blockers like propranolol or metoprolol (Toprol) also affect sleep. So can antidepressants like Zoloft, Paxil or Prozac.
Ambien is a prescription sleeping pill with a fast onset. Zoloft might exaggerate its action, however. Side effects might include nausea, dizziness and daytime drowsiness.
Q: We are tea drinkers no coffee and usually buy whatever is on sale. We change flavors occasionally, but drink black tea hot or cold.
Recently we read that some teas are healthier than others. "Brisk" tea was recommended for all sorts of things. How does this differ from, say, Earl Grey or English Breakfast tea?
We aren't into green tea, but could you enlighten us on black tea?
A: Black tea is just as rich in antioxidant compounds called flavonoids as green tea is. The exact ingredients and their balance vary from green to black tea, however, and even from one brand to another. A recent analysis showed a relatively low level of these compounds in Twinings Earl Grey black tea, for example, while Bigelow brand Darjeeling tea had three times more antioxidant components.