Question: I am a 32-year-old woman who has just been diagnosed with aphthous stomatitis. My doctor tells me that it is a very frustrating disease, for which there is no known cure. The pain in my mouth is unbearable during an outbreak, to the point that I cannot eat for days. Would you please explain the problem for me?
Answer: Your doctor's brief observation summarizes the sum of our knowledge of aphthous stomatitis, better known by its more familiar name, "canker sores."
The cause is uncertain, although the prevailing theory is of an immune attack on the mouth's normal bacteria - for reasons that are not clear.
Lacking a convenient culprit and rational cure, sufferers turn hopefully to a wide array of treatments and controls, some of them difficult to justify. Don't get me wrong; some do work, and some rather well - for some people! Cautious endorsement, indeed!
Numbing agents can ease much canker pain. The respite is brief, though.
A paste application of a cortisone - Kenalog - has its adherents, as do various mouthwashes, one containing tetracycline, an antibiotic.
I never write about canker sores without attracting dozens of letters suggesting new remedies, some commercial, some concocted in home kitchens. Some are bizarre, some seriously professional.
One dentist wrote to tell me of her apparent success with the carbon dioxide laser. She was quite enthusiastic. I have been unable to determine if the method is accepted or widely used at this point.
For less-serious cases, a water-based paste of hydrogen peroxide and baking soda seems to help.
Question: What information do you have on Gilbert's disease? I have frequent chest pains, a mitral valve prolapse, low blood pressure and high cholesterol. I am 26.
Answer: Gilbert's presents a medical columnist's dilemma. It is a condition, not a disease. It doesn't lead to any serious problems. And lots of people have it.
Gilbert's frequently shows up in my mailbag.
People who are told they have Gilbert's disease simply have livers with an offbeat way of handling bilirubin. That substance holds no mysteries. It is the residue from the breakdown of red cells, and it is recycled by the liver. If the liver lags in bilirubin recycling, the stuff ends up in skin or the whites of the eyes, which promptly turn yellow. That's Gilbert's.
Fasting, alcohol and overexertion often can trigger the buildup.
It is nothing to worry about. The yellowness lasts a few days, then subsides, leaving no permanent effects.
Most mail on Gilbert's is from readers whose doctors have casually noted the yellowness and mentioned the name without adding a calming explanation of it.
For your chest-pain symptom, you might want to read my angina report, which I am sending. Others can order a copy by writing: Dr. Donohue - No. 1, P.O. Box 5539, Riverton, NJ 08077-5539. Enclose $3 and a self-addressed, stamped (52 cents) No. 10 envelope.
Question: What is scleroderma? I found it listed in my book under skin disease.
- Mrs. J.B.K.
Answer: "Scleroderma" means "hard skin." It's a problem with the way the body makes collagen, the material that bolsters skin stability. But non-skin areas can be affected as well.
Scleroderma changes can affect collagen in various internal organs, such as the esophagus, the digestive tract, the lungs, heart and kidneys.
More women have it than men. The age of onset is usually between 30 and 50.