My 50 year old son has suffered from large and painful mouth ulcers his entire life and no over the counter remedies seem to work. He has also suffered from ankylosing spondylitis since childhood and has a stressful job. What is the best way to get rid of these sores?
Ruth Harris, Frimley, Surrey.
That sounds like recurrent aphthous stomatitis (RAS), a common if somewhat mysterious condition that causes recurring mouth ulcers.
At any one time, up to a fifth of the population suffers from RAS. Possible causes include vitamin deficiencies and trauma – for example from ill-fitting dentures.
Another recent theory is that this is due to a problem with the immune cells that protect the lining of the mouth.
In fact, recent, groundbreaking research on 500,000 participants in the UK Biobank study (a database of genetic and general health information) has confirmed a strong link between RAS and ankylosing spondylitis, your son’s immune disease (in which the spine and other parts of the body becomes inflamed as a result of a faulty immune system response).
At any one time, up to a fifth of the population suffers from RAS. Possible causes include vitamin deficiencies and trauma – for example from ill-fitting dentures
As described in your lengthy letter, your son has the typical pattern of a RAS patient, with periods when he is ulcer-free interspersed with periods when he has multiple painful ulcers at the same time.
There are a number of recommended treatments available by prescription.
An antibacterial mouthwash containing tetracycline dissolved in water is effective in treating mouth ulcers even when a bacterial infection is not present (how it helps is not clear). There is also dexamethasone mouthwash, which requires a prescription and contains a steroid drug to suppress painful sores in the mouth.
Or there’s Orabase, an over-the-counter or online gel that contains another steroid, triamcinolone. This is applied to each boil twice a day. Finally, a 2 percent lidocaine gel for local anesthesia can at least make mealtimes less uncomfortable.
Six months ago an insect bite left me with a painful and swollen right foot and ankle. Antibiotics couldn’t make it better and despite X-rays and CT and MRI scans, doctors are baffled as to why it remains inflamed.
I’m 80 and hobbling around in constant pain. It’s like walking on broken glass.
Terry Talbot, Lytham, Lancashire.
I sympathize with your frustration at not having a definite diagnosis for your condition – I suspect the problem could be lymphedema arising from the bite itself and damage to part of the lymphatic system.
This is the system that removes waste, bacteria, and other unwanted substances from tissues via the lymphatic fluid. This waste is then sent back into the bloodstream through tubes called lymphatic ducts.
It’s possible that the insect bite damaged the lymphatic channels in your leg. This, in turn, can lead to a build-up of lymphatic fluid in the tissues, a condition known as lymphedema. Bacterial organisms that thrived as a result of the bite may have been resistant to the antibiotic used to treat it, which may have made the damage worse.
But the x-rays and scans wouldn’t necessarily have picked this up, as some form of imaging is required to delineate the leg’s lymphatics.
If lymphedema is confirmed, wearing a compression stocking up to the knee will help with the symptoms. In some cases, special massage techniques are also used to disperse the fluid and reduce inflammation.
I would suggest speaking to your GP for further testing.
Write to Dr. scurr
Write to Dr. Scurr from Good Health, Chron, 9 Derry Street, London W8 5HY or by email: [email protected] – provide your contact details. dr Scurr cannot conduct personal correspondence. The answers should be viewed in a general context. If you have health concerns, consult your GP.
In my opinion… Stay away from artificial sweeteners
I worry about the amount of chemicals and additives in our food. For example, high fructose corn syrup, a sweetener, has been linked to fatty liver disease when consumed in excess.
There are also all kinds of preservatives, colorings and flavorings that some experts fear have a cocktail effect and are bad for our health.
And now I’ve read that according to draft guidelines proposed by the World Health Organization (WHO), artificial sweeteners should not be used as part of a diabetes management program nor as a means of treating obesity.
Why? According to the WHO, they tend to lead to weight gain in the long term. Artificial sweeteners have always been advertised as inert and therefore harmless.
However, recent studies are increasingly showing that some of these chemicals can affect the gut microbiome (the billions of bacteria and other microbes that play a key role in our health) and also increase blood sugar levels.
We’ve all been berated – and rightly so – about the ill effects of too much sugar in our diets. So it’s all too easy to get sucked into the world of zero-calorie colas, slimline tonics, and other chemically sweetened foods and products and trust that they’re better for us.
But based on this emerging evidence, it seems to me that the best way forward is to try to avoid foods and drinks that contain artificial sweeteners if you can.
In related news….
Could £400 glasses with closed captioning help if you’re hard of hearing? ADRIAN MONTI asks the experts for their opinion on selected products
When pain and bloating are a sign that there is too much fungus in the gut: DR. MEGAN ROSSI shows that fungi have a significant impact on our bodies
Why a gout pill can lower high blood pressure and improve your sex life: How foods like red meat and beer can raise uric acid levels