DEAR DR. DONOHUE: I have never seen you write anything about Lou Gehrig’s disease. My daughter was just diagnosed with it. Is it inherited? – R.G.

ANSWER: The medical name for Lou Gehrig’s disease is amyotrophic lateral sclerosis – ALS. Lou Gehrig, one of baseball’s greats, came down with the illness in the late 1930s, and his name has been a substitute for the official one ever since.

About 5,000 North Americans will come down with ALS this year. Its cause has not been determined. In the majority of patients – 90 percent or more – there is no family history, no inherited genetic link. It usually strikes between the ages of 40 and 70.

Certain nerve cells in the spinal cord and brain die. Those nerves send signals to muscles. Without information from nerves, muscles cannot function. They shrivel.

The first signs of trouble are often quite deceptive. People might have nothing more than a slight weakness of an arm that causes them to drop things every now and then. Or they might notice an intermittent clumsiness of a leg that causes them to trip or stumble. As time passes, muscle weakness increases, and more and more muscles are affected. People need help getting about and eventually have to use a wheelchair. ALS often affects vocal muscles and gives rise to slurred speech. Throat muscles can also be touched by it, and swallowing can be very troublesome.

Rilutek is the only medicine approved for treatment. It is not a cure, but it can slow the process a bit.

ALS is a condition that cannot be adequately addressed in a few short paragraphs. The Amyotrophic Lateral Sclerosis Association stands ready to provide information to patients and their families and to assist them in dealing with this illness. People can contact the association at 1-800-782-4747 and find it on the Internet at www.alsa.org.

DEAR DR. DONOHUE: My husband has hemorrhoids and has had to visit the doctor four or five times to have them zapped off. His doctor told him hemorrhoids just keep coming back. Should he get a second opinion? – C.P.

ANSWER: Hemorrhoids occur in three cushions of tissue in the rectal area. The cushions contain clusters of veins. They are quite similar to varicose veins of the legs.

I need to know what zapped your husband’s hemorrhoids. Were they coagulated with an infrared light? That’s an accepted and effective way of treating them. However, the hemorrhoids can come back.

Hemorrhoids can also be tied off with rubber bands, an office procedure. They can be stapled, something that makes people wince when they hear the word. Stapling is actually less painful than many other hemorrhoid treatments. It provides a rapid recovery, and there are few recurrences with it. Of course, there is standard hemorrhoid surgery. Recurrences happen with it, too, but less frequently than with other techniques.

Your husband can certainly seek a second opinion and seek an alternative method of treatment.

He can do some things on his own to prevent recurrences. He should keep his stool soft by eating a diet that is high in fiber. Fruits, vegetables and grains will help provide fiber. If food is not enough, then he should begin using bran, sold in health-food stores. And if bran doesn’t get the job done, then he can purchase fiber supplements like Metamucil, Citrucel and FiberCon. Stool softeners also work. Colace is an example. He must increase the amount of water he drinks when he increases his fiber consumption.

Dr. 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.