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 that 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 him 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. 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 may 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.
We’re sending you our Guide to Getting a Good Night’s Sleep which lists a number of medicines that interfere with normal sleep and discusses Ambien and non-drug solutions. Anyone who would like a copy, please send $2 in check or money order with a long (no. 10) stamped, self-addressed envelope: Graedons’ People’s Pharmacy, No. I-70, P. O. Box 52027, Durham, NC 27717-2027.
Ambien is a prescription sleeping pill with a fast onset. Zoloft may exaggerate its action, however. Side effects may include nausea, dizziness and daytime drowsiness.

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