Dear Dr. Donohue — I have had a persistent cough for several years. I never smoked. The doctor has examined my throat and says it's due to acid reflux. I have been inhaling albuterol, which doesn't help. Any suggestions?
A cough lasting longer than eight weeks is called chronic. Yours qualifies for that name. (1.) Airway inflammation, (2.) narrowing of the airways as happens in an asthma attack and (3.) growths in the chest pressing on the airways are some of the anatomic pathologies that bring on a chronic cough.
Three illnesses are the frontrunners as cough causers. They are asthma, postnasal drip and gastroesophageal reflux disease (GERD), the heartburn malady.
Asthma should respond to albuterol, the medicine you've been taking. Since it hasn't, that puts the asthma diagnosis out of running.
Postnasal drip is the constant trickling of thick mucus into the throat from the nose and sinuses. Antihistamines and decongestants often can stop this kind of cough. You didn't mention any postnasal drip complaints, so it, too, can be eliminated.
Acid reflux — GERD, heartburn, whatever you want to call it — is the diagnosis given to you. It's the upward spouting of stomach acid into the esophagus. In some people, this spouting stimulates cough receptors in the lower part of the esophagus and leads to coughing. You might not have any heartburn symptoms, only the coughing. Or the stomach acid can travel up the esophagus into the throat and trigger coughing. In any case, a trial of medicines that suppress stomach acid production will show you if this is the correct diagnosis. Two such medicines are Prilosec (omeprazole) and Aciphex (rabeprazole).
Other causes are possible. Lung cancer must be considered, but it's not likely to be a cause in your case. You would be suffering other symptoms if it were. Have you considered seeing a lung specialist, a pulmonologist?
Dear Dr. Donohue — Some time ago, you discussed eggs and cholesterol. Will you send me a copy of that article? My friend, the owner of a restaurant, is interested.
Eggs have had an unnecessarily bad reputation. Their yolk contains 200 mg of cholesterol, and the daily limit is set at 300 mg. So one egg pretty much reaches the daily limit. However, most blood cholesterol comes from the liver's production of it and not from food we eat. It's been shown that people who eat six eggs a week have no more heart attacks or strokes than do those who eat no eggs.
You can't find a better nutritional bargain than an egg. It has 6 grams of protein, some iron, zinc, folate (a B vitamin), B-12 and vitamin E. All that comes with only 70 calories and at a relatively cheap price.
Write Dr. Donohue at P.O. Box 536475, Orlando, Fla. 32853-6475.