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Recurrent apthous ulcers, diet, treatment and biopsy - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Good Posted in: X-ray, Lab tests and Scans
Answered by

General & Family Physician
Practicing since : 2009
Answered : 631 Questions
User :   Hi
Doctor :   Hi
Doctor :  
How can I help you?
User :   I am suffering frm mouth ulcer
User :   from a long time
Doctor :  
Ok, so are you not relieved with this problem?
User :   yes..
User :   its is same
User :   and it is contunues
Doctor :   Do you have the problem daily?

User :   yes now it is daily
Doctor :  
How many do you have now?
User :   5
Doctor :  
Any tests done yet?
User :   before that I had two
User :   those were relieved on friday... soon after that I got five
User :   I have got that blood test
User :   after that I had ultrasound and city scan
User :   but that was from some other purpose
Doctor :  
Now you have to get the a better work up for these
Doctor :  
usually nutritional deficinecy, some genetic reasons are cause of the recurrent apthous ulcers
User :   ok.. tell me what to do?
Doctor :   Blood tests, ANEMIA profile

User :   that was done last time
User :   should I explain you report outcome
User :   ?
Doctor :  
yes
Doctor :  
Any biopsy done over the ulcer?
User :   no
Doctor :  
I guess I have asked you to get it done
Doctor :  
few months back
Doctor :  
Do you have ulcers any where else like private parts?
Doctor :  
Do you smoke?
User :   no I do not have it at any other part and I do not smoke
Doctor :   Any family member has the same?

User :   bi
User :   no
Doctor :   Biopsy?
Doctor :  
Family members have the same?
User :   no in family member no one has
User :   this proble
Doctor :  
Biopsy?
User :   no I have not get it tested
User :   should I go for culture testing or biopsy?
Doctor :   Biopsy
Doctor :  
Look you have to get these tests done
User :   ok.. I will get tested
User :   what is the purpose of biopsy?
Doctor :  
1) Complete blood cell count
2) Hemoglobin test
3) White blood cell count with differential
4) Red blood cell indices
5) Iron studies (usually an assay of serum ferritin levels)
6) Red blood cell folate assay
7) Serum vitamin B-12 measurements
8) Serum antiendomysium antibody and transglutaminase assay (positive in celiac disease)

User :   ok
User :   actualy I went to a physician.. he said me not need to go for biopsy because in any case you will have to for same treament
Doctor :   An ENT surgeon shall help you in identifying which clincal type it is
Doctor :   Ofcourse but you have to know the cause of it right

User :   I had been to ENT specialist, dentist, nurologist, gasologist
User :   no one took it so seriously
Doctor :  
Ok
Doctor :  
Then they felt that the problem resolves on its own
Doctor :  
within few years
User :   and then to lots of ayurvedic medicine
Doctor :  
usually by mid thirties
Doctor :  
or late thirties
User :   you mean to say by age it would disappera automatically
Doctor :   yes
Doctor :  
90% of times
User :   ok
Doctor :  
Since you have seen the doctors physically and they could not help you
Doctor :  
I know they suggest you topical steroids
Doctor :  
yeah they are actual first line of treatment
User :   yes.. in case if I apply steroid on it it relieved soon
Doctor :  
Let me suggest you few more
Doctor :  
1) Brush with a small-headed, soft toothbrush
User :   or one more thing is that.. if I take whiskey for some time regular or on alternate days
User :   then it disapperead
Doctor :   Ok
Doctor :  
2) avoid eating particularly hard or sharp foods (eg, toast, potato crisps) and avoid other trauma to the oral mucosa.

User :   in that case even if I do not take care of food
User :   can you figure it out anything out of it?
Doctor :   Pain killers should be avoided
Doctor :  
as they are predispose to ulcers
Doctor :  
too
User :   if I take whiskey I got relief from mouth ulcer
User :   if I take beer it worsen situation
Doctor :  
That is because of the soothening action of alcohol
Doctor :  
Chlorhexidine mouth washes
Doctor :  
Are you there?
User :   yah I am here
Doctor :  
Did you follow?
User :   yes
User :   is it beneficial if rinse with alcohol
Doctor :  
yes
Doctor :  
You can use any way to relieve the discomfort that bothers you
Doctor :  
All the more check for those things, Vitamin B12, Folate deficiency
User :   ok
Doctor :  
and Iron assay in the blood
Doctor :  
I shall do one thing, I shall ask my Customer relationship team to call you up and help you in getting these done
Doctor :  
at a better rate
User :   sure pls. do that
User :   or if you suggest any good doc. in noida who can help me out on this
Doctor :  
If they are fine, then it could be an immunological entity
Doctor :   then I shall refer you to a Immunologist
Doctor :  
in Delhi
Doctor :  
so let us get a profiling done first
Doctor :  
Ok
Doctor :   The reports which you have now were old and cannot be clinically be helpful
Doctor :  
These change
Doctor :  
Please confirm you phone number and email ID
Doctor :  
YYYY@YYYY
Doctor :   Phone??
User :   0000
User :   and 0000
User :   I will wait for call
Doctor :  
Do you have problem in stool
Doctor :  
like diarrhoea
Doctor :  
mucus in the stool
Doctor :  
food allergies
Doctor :  
any of them or any one of them
User :   what is diarrhoea?
Doctor :  
loose and watery stool
User :   in the morning I have go three times to get freshed
Doctor :  
or loose stool
User :   yes I have that
Doctor :   everyday??
User :   yes it was everyday
Doctor :  
three times??
User :   but few days back I took some treatment then after its not so much wattery and loose
User :   yes everytime three times
Doctor :   Did you mention this to Gastroenterologist

Doctor :  
about the recurrent apthous ulcers
User :   yes
Doctor :  
Ok
User :   that can be a reason?
Doctor :   Some recurrent ulcers are associated with few immunological diseases
Doctor :   like coeliac

User :   what is immunological desease?
User :   coeliac?
Doctor :  
lacking immunity
Doctor :  
certain foods cause allergies called gluten
User :   ok
Doctor :   that is celiac disease
Doctor :  
Ok let us get these tests done and see if there is some problem or not
User :   then how to figure out this allergy problem
Doctor :   Any way you have to follow the same
Doctor :  
treatment of topical steroids
Doctor :  
and mouth washes
User :   ok
User :   topical steriods?
User :   same P-solon and wyth
Doctor :   yes
User :   apply on ulcers
Doctor :  
you were taking that'
Doctor :  
yes
User :   yes.. in case situation is very bad only then I apply it
Doctor :  
Ok
Doctor :   Ok my CRM team calls

User :   what about (kattha) pan with katha
Doctor :  
you and get the tests done
Doctor :  
No pan
Doctor :  
please
User :   is it beneficial in mouth ulcer?
Doctor :  
They irritate the oral mucosa
Doctor :  
badly
User :   ok
Doctor :   Follow my other recommendations till then
User :   ok
Doctor :  
is there anything else I can help you with?
User :   should I go for all those test which you have mention above?
Doctor :  
Yes
Doctor :  
To find out the cause
User :   ok
Doctor :  
If there is an nutritional def
Doctor :  
we can treat it positively
User :   ok
Doctor :  
Please fill the feedback form say done when done
Doctor :  
Thanks for consulting me
Doctor :  
Bye for now
Question is related to
Diseases and Conditions
Drug/Medication
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