DEAR DR. GOTT: Please help me. I am an 88-year-old female who has had irritable bowel syndrome (IBS) for a few years now. I would give anything to eat fresh fruits and vegetables again.

My condition is so bad that I have no warning at all. I have to wear a special absorbent undergarment whenever I leave the house. It is embarrassing. Two years ago, I had surgery to remove about eight inches of my bowel that had become dilated.

My doctor gave me a small printout about IBS. I am at my wits' end and hope you can give me some advice about what I can do. I was told that there is nothing that can be done for me, but I refuse to believe it. There has to be something that can help me.

DEAR READER: Irritable bowel syndrome used to be a diagnosis of exclusion, meaning all other causes had to be ruled out first. Today, patients can be diagnosed with IBS if they meet certain criteria.

The printout you received from your physician is incredibly outdated. It is a reprint from a book copyrighted in 1994. That makes the information 15 years old and, in terms of medicine, practically archaic.

Irritable bowel syndrome was once considered a type of colitis (inflammation of the large intestine), but today it is known that this is not so. IBS is considered a functional disorder, meaning the primary problem lies with the working function of the bowel rather than a physical or structural deformity.

There are three types of IBS: with constipation, diarrhea or with alternating bouts of both. Symptoms include constipation, diarrhea, bloating, intestinal gas, abdominal pain or cramping and mucus in the stool.

Treatment often includes avoiding foods that worsen the symptoms. This may not help everyone, since only some have certain foods that trigger a problem. Eating fiber to add bulk to the stool and avoiding gas-causing foods may be beneficial for both constipation and diarrhea but must be done carefully and with physician approval to ensure symptoms are not worsened. For those with constipation-type IBS, increasing fluid intake may also help. Those with diarrhea-type IBS may benefit from over-the-counter anti-diarrheal medications, such as Imodium or Digestive Advantage. It is also important that fluid intake is increased to make up for what the body loses with each bowel movement.

There are a few available prescription medications. These are considered only if more conservative measures have failed, owing to the risk of side effects.

Since you are having severe symptoms, I urge you to request a referral to a gastroenterologist. Your condition needs to be re-examined, and treatment options should be discussed. Perhaps you do not truly have IBS. If your symptoms did not appear until after the surgical removal of part of your bowel, you may be suffering a complication of surgery. To the best of my knowledge, IBS does not cause physical abnormalities within the bowel, so if your IBS was the reason for the surgery, you need to be re-evaluated to determine the real cause of your symptoms.

If you are already under the care of such a specialist, request a referral for a second opinion. Your quality of life has clearly declined. Don't be afraid to ask questions. Under no circumstances should you leave the physician's office without fully understanding his or her explanations, suggestions and recommendations.

To provide related information, I am sending you copies of my Health Reports "Irritable Bowel Syndrome" and "Constipation and Diarrhea." Other readers who would like copies should send a self-addressed stamped No. 10 envelope and a check or money order for $2 per report to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

Dr. Peter Gott is a retired physician and the author of the book "Dr. Gott's No Flour, No Sugar Diet," available at most chain and independent bookstores, and the recently published "Dr. Gott's No Flour, No Sugar Cookbook."