R.B. Answer:

Dear Dr. Roach:

Iam 92 and in exceptional health. I have irritable bowel syndrome, and my digestive system goes through a cycle of constipation and loose bowels. I also have episodes of incontinence with clear liquid. I would appreciate anything you can tell me about this troubling condition. —

While fecal incontinence is common, many people won’t talk about it with their doctors. But there is effective treatment, and it starts with an accurate diagnosis.

Irritable bowel syndrome affects more than one person in 10, and although it does not reduce life expectancy or predispose a person to cancer, it can cause a dramatic reduction in quality of life and in people’s social and work lives. It is more common in women.

Some people with IBS have only constipation; others have only loose stools or diarrhea. Some people, like you, have mixed symptoms. To be sure of the diagnosis, other conditions — some potentially serious — need to be excluded. This is especially true for celiac disease, but also other causes of malabsorption and microscopic colitis.

Initial management of irritable bowel includes dietary changes ranging from avoidance of problem foods (e.g., beans, onions, raisins and other gas-producing foods) to a low-FODMAP diet, which is much more restrictive and should be recommended in consultation with a registered dietitian nutritionist. Because incontinence is much more likely with liquid stool, managing the diarrheal aspect of your IBS is critical. This usually means increasing fiber. Fiber for constipation is effective because it carries more water in the stool, but it is effective in diarrhea for many people as well, since it absorbs excess water.

Dear Dr. Roach:

I have a crack in my thumbnail. The crack opens up as the nail grows, and I have to trim it back. It is painful if it gets caught on anything. Is there anything I can do to heal the nail and allow it to grow back normally? —

E.G. Answer:

It depends on how the nail is cracked. Sometimes just a drop of cyanoacrylate (the ingredient in most superglue) will seal up the crack until the nail grows back. I also have seen methods using nail polish and carefully trimmed material from a tea bag.

You can try a visit to your local nail salon. They likely have seen this problem and can use one of these methods (or another) for you.

Dear Dr. Roach:

Iam wondering if forskolin is really safe for weight loss. Also, when you reach your goal and stop taking it, will all the weight come back on if you haven’t changed your eating habits? —

S.C. Answer:

Forskolin is an extract from the Indian Coleus plant. I found two studies on its use in weight loss, neither of which showed any significant weight loss, although there was some decrease in body fat as a percentage of total weight.

Thus, I can’t recommend it as an effective supplement for weight loss. To answer your larger question, if you were to take an effective medicine for weight loss, then stop the medicine and return to your previous levels of exercise and dietary intake, you would be expected to gradually return to your previous weight.

Perhaps you have heard about the “Freshman 15,” an expression that refers to the amount of weight a student gains during his or her first year at college. But is this a prerequisite for college campus life or just a myth? Students certainly have many stressors when beginning their new journey — a new place to live, new roommates, finding classes and sometimes adjusting to being away from home for the first time. For many of us, food is comfort, and our emotions can cause some stress eating. The good news is that the “Freshman 15” is not a college requirement. While college students and non-college students of this same age may gain some weight, the actual amount may vary but averages only two to three pounds in the first year, according to a study by the Ohio State University.

“The best way to handle the adjustment and beat the weight gain is to have a plan,” says Marta Wright, a registered dietician with Kettering Weight Loss Solutions in Kettering. “Be prepared for stress. If you are a stress eater, keep only healthy snacks available.”

Healthy snack options include apples with peanut butter, vegetables, Greek yogurt and string cheese. If you want occasional chips, then only have the smaller bags on hand rather than the large bags to avoid overeating. Plan for “walk breaks” and “talk breaks” with friends to help with boredom, study stress and the temptation to eat. Do not skip breakfast. “Breakfast keeps our metabolism going, provides us with energy, and prevents us from overeating throughout the day,” Wright says. “Breakfast should contain some protein to keep us full longer.” Some easy breakfast meals include yogurt with nuts and fruit, protein shakes or bars, fruit and peanut butter, toast and peanut butter, hard boiled eggs and fruit, or cottage cheese and fruit.

The dining hall on campus can be an enemy or a friend depending on the choices you make, Wright says. Avoid the high-calorie foods and oversized portions. Do not choose buttered, fried, creamed and au gratin food. Visit the salad bar but avoid bacon, croutons and excess dressing. Use fruit as a dessert or practice portion control if you indulge in a sweet treat.

Do not drink your calories, whether it is soda, juice or sweet tea. Remember that coffee drinks can contribute significant calories. Avoid calorie-laden lattes and frappachinos when you need the caffeine boost. There are many sugar-free alternatives that taste just as good as the regular options.

Stay active, keep a healthy meal plan, keep your weight in check and stress levels as low as possible. These are habits that can stay with you for the rest of your life.