DEAR DR. DONOHUE: I am writing you to get a message out there about Marfan’s syndrome. I am the mother of a very tall 14-year-old boy. He developed scoliosis of the spine, and his sternum protruded. He wore a brace for his back. My mother-in-law brought to my attention that tall kids with scoliosis might have a heart condition. She had seen a documentary on Marfan’s syndrome. Our doctor ordered an echocardiogram on my son, and he was found to have a dilated aorta. He has Marfan’s syndrome. I want other parents to learn about this to prevent the possible sudden death these children face. – L.R.

ANSWER: Marfan’s syndrome is a genetic condition in which there is a defect in the tissues that support the body – the bones – and hold organs in place – ligaments and tendons. Affected people are tall, with legs and arms disproportionately elongated compared with their trunks. Often they have spinal curvature – scoliosis. Their breastbone (sternum) can have a central depression, or it can jut outward. Marfan’s patients tend to be nearsighted, and their eye lenses often dislocate.

The most dangerous aspect of Marfan’s lies with the heart and the aorta. Heart valves might be defective. The aorta can be quite wide and quite weak. If it is, there is the threat that it will split without warning and lead to a massive and fatal hemorrhage. Such was the fate of a 1986 female Olympic volleyball player who was unaware she had the syndrome. And such has been the fate of a number of athletes who died a sudden death on the playing field from a ruptured Marfan’s aorta.

Knowledge of his condition has freed your son from a Marfan-related catastrophe. Medicines can greatly reduce the threat of death, and surgery, when necessary, can correct valve and aorta problems.

Do you and your son (and all Marfan’s patients) know about the National Marfan Foundation? It exists to provide you with information and help. The foundation has chapters all over the country, and your son might want to join one. Contact the foundation at 1-800-8-MARFAN or via www.marfan.org. You won’t regret doing so.

DEAR DR. DONOHUE: I have a hernia that’s working its way into the scrotum. I am 74. Are there alternatives to having an operation? – V.F.

ANSWER: Hernias are anatomical problems whose treatment entails correction of the anatomical defect. The defect is a weakness in a muscular wall that keeps organs and tissues in place. Through the weak point, organs and tissues can protrude.

Most hernias are in the groin, and most are in men. During fetal life, the testicles migrate from the abdomen into the scrotum. During their descent, they leave a weak spot in the groin, and that’s why men are prone to groin hernias. (Women also get them, but in smaller numbers and for different reasons.)

DEAR DR. DONOHUE: My husband is 88 years old and eats ice almost without stopping. He is very anemic.

I have heard that eating ice is an indication of anemia, but I have also heard that it causes anemia. Can you tell me what eating ice has to do with anemia? – E.B.

ANSWER: The compulsive eating of substances not considered foods and not having any nutritive value is called pica. Such substances include ice, clay, starch, grass, paper and even dirt.

Pica can be a sign of iron-deficiency anemia. It does not cause anemia. Some speculate that iron is involved with certain appetite centers of the brain. When there is a deficiency of iron, those centers send out signals that turn on a desire for bizarre food substitutes.

When the iron lack is corrected, the cravings usually stop.

DEAR DR. DONOHUE: I hope you will write something about H. pylori. I have a dear friend who has it, and she is really sick from the medicine given for it. – D.H.

ANSWER: H. pylori – Helicobacter pylori – is a bacterium whose significance has come to light only recently. It lives in the mucus lining of the stomach and is found in about half of those over 60. Most of those who harbor the germ suffer no consequences. However, it can be involved in generating ulcers, and in a few cases, it is implicated in some kinds of stomach cancer.

Modern ulcer treatment entails ridding ulcer patients of H. pylori to speed ulcer healing and to prevent ulcer recurrence. Ulcers recurred frequently in the days before this bacterium’s role in their formation was discovered.

DEAR DR. DONOHUE: I have a question about Coumadin, which I have been taking since I had a TIA. Can it affect my blood circulation and cause ED? Could it cause a coolness in the lower parts of my legs? And does the extended use of Coumadin have any effect on my joints, such as hips, knees and shoulders? – R.S.

ANSWER: Coumadin is one of medicine’s most powerful anticoagulants, and it is often given to a person who has had a TIA – transient ischemic attack – to prevent a recurrence or a stroke. A TIA is a temporary neurological deficit, like an inability to speak, numbness of the hand or leg, or weakness of the hand or leg. The deficit comes about from a transient blockage of blood flow in a brain artery.

Coumadin’s effect on blood circulation should be an improvement, since it prevents clots from forming in blood vessels.

I cannot find any evidence that it causes erectile dysfunction, coolness in the legs or arthritis. If it does, it happens to a very small number of people, so small that a cause-and-effect relationship has not been firmly established.. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.