My 50-year-old son has suffered with giant and painful mouth ulcers all his life and no over-the-counter treatments appear to work. He’s additionally had ankylosing spondylitis since childhood and has a nerve-racking job. What’s the easiest way to eliminate these sores?
Ruth Harris, Frimley, Surrey.
This feels like recurrent aphthous stomatitis (RAS), a standard though considerably mysterious situation that causes recurrent mouth ulcers.
At anyone time as much as a fifth of the inhabitants suffers from RAS. The varied potential causes embody vitamin deficiencies and trauma — for example, because of ill-fitting dentures.
Another latest idea is that it’s resulting from an issue with the immune cells that defend the liner of the mouth.
Indeed, latest, groundbreaking analysis on the five hundred,000 contributors within the UK Biobank examine (a database of genetic and normal well being data) has confirmed a robust affiliation between RAS and ankylosing spondylitis, the immune situation your son has (the place the backbone and different components of the physique grow to be infected because of a defective immune system response).
At anyone time as much as a fifth of the inhabitants suffers from RAS. The varied potential causes embody vitamin deficiencies and trauma — for example, because of ill-fitting dentures
According to the outline in your longer letter, your son has the standard sample of an RAS sufferer, with intervals when he’s ulcer-free, punctuated by occasions when he has a number of painful ulcers all of sudden.
There are quite a lot of beneficial therapies which can be accessible on prescription.
An antibacterial mouthwash containing tetracycline dissolved in water is efficient in treating mouth ulcers, although there’s no bacterial an infection (it’s not clear the way it helps). There can be dexamethasone mouthwash, which is prescription-only and comprises a steroid drug to suppress painful irritation within the mouth.
Or there may be Orabase, a gel accessible over-the-counter or on-line that comprises a unique steroid, triamcinolone. This is utilized to every ulcer twice each day. Finally, a 2 per cent lidocaine native anaesthetic gel can at the very least make mealtimes much less uncomfortable.
Six months in the past, an insect chunk left me with a painful and swollen proper foot and ankle. Antibiotics didn’t make it any higher and, regardless of X-rays and CT and MRI scans, medical doctors are baffled by why it stays infected.
I’m 80 and hobbling round in fixed ache. It’s like strolling on damaged glass.
Terry Talbot, Lytham, Lancashire.
I SYMPATHISE along with your frustration at not having a agency analysis to your situation — I think the issue could also be lymphoedema arising from the chunk itself and injury to part of the lymphatic system.
This is the system that removes waste, micro organism and different undesirable substances from the tissues through lymphatic fluid. This waste is then drained again into the bloodstream by way of tubes referred to as lymphatic channels.
It is feasible that the insect chunk broken lymphatic channels in your leg. This in flip can result in a build-up of lymphatic fluid within the tissues, a situation generally known as lymphoedema. Bacterial organisms that flourished because of the chunk might have been immune to the antibiotic used to deal with it, and this will likely have exacerbated the injury.
But the X-rays and scans wouldn’t essentially have detected this, as a particular type of imaging is required to stipulate the lymphatic channels of the leg.
If lymphoedema is confirmed, then sporting a compression sock proper as much as the knee will assist with signs. In some circumstances, specialised therapeutic massage strategies are additionally used to disperse the fluid and ease irritation.
I might counsel speaking to your GP about additional investigations.
Write to Dr Scurr
Write to Dr Scurr at Good Health, Daily Mail, 9 Derry Street, London W8 5HY or e-mail: [email protected] — embody contact particulars. Dr Scurr can not enter into private correspondence. Replies ought to be taken in a normal context. Consult your individual GP with any well being worries.
In my view… Steer away from synthetic sweeteners
I’m nervous in regards to the quantity of chemical compounds and components in our meals. For occasion, high-fructose corn syrup, a sweetener, has been linked to fatty liver illness if consumed in extra.
There are additionally all types of preservatives, colourings and flavourings that some consultants concern could have a cocktail impact, damaging our well being.
And now I learn that, below draft tips proposed by the World Health Organisation (WHO), synthetic sweeteners shouldn’t be used both as a part of a diabetes administration programme or as a approach of serving to with weight problems.
Why? Because, says the WHO, they’re extra more likely to lead to weight achieve within the long-term. Artificial sweeteners have all the time been promoted as inert and due to this fact innocent.
But more and more, latest research present that a few of these chemical compounds have an effect on the intestine microbiome (the billions of micro organism and different microbes that play a key position in our well being) and may additionally truly elevate blood-sugar ranges.
We have all been berated — fairly rightly — in regards to the opposed results of an excessive amount of sugar in our diets. It is due to this fact all too straightforward to be lured into the world of caloriefree cola, slimline tonics and different chemically sweetened meals and merchandise, trusting that these are higher for us.
But on the premise of this rising proof, the perfect course, it appears to me, is to attempt to keep away from meals and drinks that comprise synthetic sweeteners, in case you can.
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