Bronchiectasis is a cough that won’t stop

DEAR DR. DONOHUE: For two years, I had a cough that was constant. I didn’t feel all that sick, and I saw a number of doctors without getting an answer. I also tried numerous medicines, without any relief. I just changed doctors, and the new doctor started from square one with a chest X-ray. The results suggest bronchiectasis, and I am scheduled for a lung scan. I am not familiar with this. Will you fill me in? — R.K.

ANSWER: The “bronchi” of bronchiectasis (BRAWN-key-EK-tuh-siss) are the airways, the breathing tubes. “Ectasis” means those airways are stretched out of shape. That makes them reservoirs for thick, sticky sputum. It’s a condition somewhat like chronic bronchitis, the cigarette smoker’s ailment, but somewhat unlike it, too. It has nothing to do with smoking. More than 100,000 Americans have it.

Its principal sign is a lasting cough that brings up viscid sputum. Shortness of breath from little effort is another sign. Affected people are prone to repeated respiratory infections.

What causes it? Some get it from their genes, a family affair. Others have a defect in their immune system. For a few, it’s associated with another illness. Rheumatoid arthritis is an example of one of those illnesses. Most, however, develop it from a past severe lung infection or infections.

A chest X-ray often can show the changes of bronchiectasis, but a high-resolution computed tomogram (a special lung scan) provides the best and clearest evidence of it.

Most patients are able to contain the problem by nipping respiratory infections quickly. That means antibiotic treatment. Some must go on a daily or three-times-weekly schedule of antibiotics to prevent infection. In a few instances, surgical removal of sections of affected lung all but cures the problem.

DEAR DR. DONOHUE: Why do I get frequent fever blisters in my mouth? They last for days and then go. Does this have anything to do with irritable bowel syndrome, or nutrition or lack of nutrition? — Anon.

ANSWER: Fever blisters are also called cold sores. They’re caused by the herpes virus type 1, HSV-1. Almost 80 percent of adults are hosts to HSV-1, and, of that number, up to 40 percent have recurrent outbreaks. The virus stays with people for life. A fever blister usually occurs at the bottom and side of the lower lip. At first it is a number of small blisters on a red base that eventually form a golden crust. Treatments of it include oral acyclovir, valacyclovir, famciclovir and acyclovir cream and penciclovir cream.

You have sores inside your mouth. Those sound more like canker sores. Have your doctor examine them next time they appear. They call for a different approach.

DEAR DR. DONOHUE: Please explain osteochondromatosis and creatinine. I have the first problem in my knee. I am a chronic kidney patient, and creatinine seems to be of interest to my doctors. — M.O.

ANSWER: Osteochondromatosis is nests of cartilage that sprout in the lining of a joint, often the knee. Those islands of cartilage can become infiltrated by calcium. Some might break loose to cause pain and joint locking. If they do, they can be removed. The cause is not known. There’s an inherited form of osteochondromatosis, but that’s not your kind.

All humans produce creatinine from creatine, a muscle component. They produce the same amount of it every day. It is filtered by the kidneys into the urine. A rise in blood creatinine, therefore, indicates that the kidneys are not working well. It’s a valuable test of kidney function.

DEAR DR. DONOHUE: Do black stools indicate bleeding? My stools have turned black. — O.V.

ANSWER: Tarry black stools can indicate bleeding from the stomach or small intestine. This is a question easily answered with a simple test that can be conducted right in the doctor’s office with a small specimen of stool.

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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