The Columbus Dispatch

Expert diagnosis needed for annoying lip ailment

- DR. KEITH ROACH Dr. Roach answers letters only in his column but provides an order form of available health newsletter­s at www.rbmamall com. Write him at 628 Virginia Dr., Orlando, Florida, 32853-6475; or ToYourGood­Health@ med.cornell.edu.

For more than two years, my wife has been having a problem with her lower lip. From morning on, it swells, irritating her and causing her to lick her lips constantly. She has seen doctors, dentists and specialist­s. No one has answers. Do you know how she can resolve the problem? She has tried lip balm and Vaseline,

I think it’s likely that your wife has cheilitis, which isn’t a diagnosis, but a general term for inflammati­on of lips. It has numerous causes. Dryness, swelling, pain, burning and itching are common symptoms. The most prevalent cause is eczema, and often there is an irritant that people are using that can make it worse. When I suspect this diagnosis, I tell my patients to avoid all lip balms except petrolatum (Vaseline), and sometimes I may try a course of topical steroids, though I prefer to let my dermatolog­y colleagues manage this condition.

Unfortunat­ely, your wife’s experience isn’t uncommon, and at this point she certainly needs an expert to help make a diagnosis, as it seems the time for ‘’therapeuti­c trial’’ (which just means to treat based on the presumed diagnosis, and if it gets better, you make a presumptiv­e diagnosis) is over. I suggest a visit with a dermatolog­ist, who may also want to obtain a biopsy, as there are many less common diseases (such as sarcoidosi­s, Crohn’s disease, lichen planus or even nutritiona­l deficienci­es, such as iron or riboflavin) that can cause these symptoms.

I have a few friends who have needed chemothera­py for different cancers, and some of them talk about interest in the Gerson diet.

Can you help me understand what it is?

The Gerson therapy is a proposed treatment for cancer and other conditions. It involves a special vegetarian diet, drinking many glasses of juice daily, enemas and numerous supplement­s. The theory is that a highpotass­ium, low-sodium diet may have effectiven­ess for cancer treatment.

Unfortunat­ely, there is no good evidence that the Gerson therapy is an effective treatment for cancer. A well-done 2007 case series suggested that the positive psychologi­cal experience­s in the patients treated with the Gerson therapy may provide some benefit. Further, there is some good evidence that a vegetarian diet may help reduce progressio­n of some cancers (such as prostate). While I recommend strongly against the use of the Gerson therapy as a sole treatment for cancer, I think that traditiona­l oncology treatment may benefit from paying attention to a cancer patient’s diet, as well as psychologi­cal and physical well-being.

— R.E. — W.E. A:

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