DEAR DR. DONOHUE: A reader wrote to you concerning a cough he had had for 10 years. During that time, he had seen many physicians and taken many medicines, to no avail.

You were able to identify that cough as being one that is uncommon. The reader followed your advice and the properly prescribed medicine was able to get rid of it.

Can you retrieve that information, and give me the name of it? — J.V.

ANSWER: I am sorry. I can’t find the article, and I do keep track of everything I write. I also rarely forget letters that pat me on the back. Let me give you a fresh look at chronic cough — a cough lasting for more than two months.

For nonsmokers, postnasal drip, asthma and gastroesophageal reflux disease (GERD) are the three most common causes of a chronic cough. GERD is heartburn, the upward splashing of stomach acid and digestive juices into the esophagus. The splashing can reach the throat and from there enter the airways to cause coughing. And that person might never experience any heartburn pain. Once these illnesses are treated, the cough goes.

For smokers, chronic obstructive pulmonary disease (emphysema and chronic bronchitis) and lung cancer are the two most likely explanations for a lasting cough.

Rare causes have to be considered. Bronchiectasis, TB, adult whooping cough and a condition called eosinophilic bronchitis are examples.

I apologize for not answering your question. I am trying to get across that an exhaustive investigation is the way to find the cause of a cough that won’t stop.

DEAR DR. DONOHUE: My son is 54. He has Tourette’s syndrome. He can’t afford medication for it. What can be done? — B.G.

ANSWER: Tourette’s syndrome is a problem with tics, involuntary movements or vocal outbursts. Sniffing, snorting, grimacing, shoulder shrugging, poking and jumping are some of the motor tics. Repetitions of words or syllables are examples of vocal tics. The illness usually begins in childhood. Frequently, the tics lessen with age.

Have your son contact the Tourette Syndrome Association at www.tsa-usa.org. Canadians can contact the Tourette Syndrome Foundation of Canada at www.tourette.ca. One of these organizations can tell your son if there are programs to help needy patients.

DEAR DR. DONOHUE: My granddaughter, age 5, was diagnosed with Henoch-Schonlein purpura. After five days, she was given a cortisone drug, which relieved her stomach pain, and she was discharged. How did she get this disease, and what should we expect? — M.A.

ANSWER: Henoch-Schonlein purpura mostly happens to children, and mostly to children between the ages of 2 and 8. It often follows on the heels of an ordinary cold. No one knows the exact cause. It’s an inflammation of small arteries, small veins and the tiny blood vessels that connect those two, the capillaries. Fatigue and fever are seen at the onset. An outbreak of a pinkish rash occurs that progresses into large and small bruises. “Purpura” is the medical word for “bruise.” The bruises come in crops. As one crop fades, another appears. Other symptoms include abdominal pain due to bruising in the digestive tract. Kidneys might be affected. Joints may swell and hurt, especially the knees and ankles.

As frightening as this illness is, most youngsters have an excellent prognosis and do not suffer any permanent damage.

The illness, however, may recur in the first year or so after the initial onset.

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. Readers may also order health newsletters from www.rbmamall.com.

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