ArcaMax

DEAR DR. ROACH: Ten to 15 years ago, I had to constantly clear my throat and it was driving me and everybody around me nuts. You had written a column about chronic throat-clearing. In the article, you talked about how after all the serious things had been eliminated there was an expensive test to check out the throat or you could just prescribe gabapentin to see if that helped. I showed the article to my gastroenterologist, and he dismissed it and upped my omeprazole from 20 to 40 mg/day. I didn't think it would work, and it didn't.

Not long after, I saw my family doctor and he said prescribed 100 mg gabapentin twice a day to try it. It worked, much to my relief and for the people around me. I have told every medical person I've ever come in contact with, why I was taking gabapentin, and not one has heard of this use for gabapentin. I checked online and the medical sites listed many potential causes and cures. Not one listed gabapentin when no real cause could be found. I feel very lucky to have seen your column and that my doctor agreed to prescribe it. Is there any way to get the word out? I have to think there may be a lot of other people who may get relief with this. -- G.S.

ANSWER: I have written about laryngeal neuropathy -- an uncommon condition causing chronic cough or throat clearing -- several times, and each time I do, I get letters from people saying it was effective in treatment of the cough they had had for years. Unfortunately, in my own patients, I have found it doesn't work nearly as often as I hope. That's probably because there are many causes of chronic cough, and gabapentin is effective only for that one, specific, unusual case.

What your gastroenterologist treated you for, gastrointestinal reflux disease, is a much more common cause of cough, as are asthma and postnasal drip. There are numerous other unusual and rare causes of cough (I recall one of my professors presenting a case of cough due to impacted earwax), but once in a while, gabapentin for laryngeal neuropathy can be life-changing.

DEAR DR. ROACH: I have never before written or phoned regarding a column. However, your recent column from a woman noting her physicians did not introduce themselves struck a nerve with me. I am 78 and have multiple health challenges. I see a lot of different doctors/specialists. I am very social, even when my chronic pain kicks in. My experience is that the professional staff, including the doctors, are very, very busy, and they may have just delivered bad news to the patient before me. My approach and purpose for getting names and letters after names is to gently say: "And who are you and what do you do here? How is your day going?" I have never had a bad experience with this approach. Remember, courtesy goes both ways! -- BT

ANSWER: I thank you, B.T., and think your gentle approach is wise. Many people wrote that they too did not know what each person's name and role was in their health care.

========

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

(c) 2025 North America Syndicate Inc.

All Rights Reserved