IMONINHALED TOBACCO PRODUCTS
Question: Health reports often warn about the dangers of cigarette smoking. What are the risks of using noninhaled tobacco products such as pipes, cigars, and chewing tobacco?
Answer: The fact is that many pipe and cigar smokers do inhale, even unconsciously. Aside from the known risks of inhaled smoke, the main danger is cancer of the mouth, tongue and throat. The risk is greater in people who also drink a lot of alcohol. In addition, nicotine is easily absorbed through the lining of the mouth, and that increases the risk of coronary heart disease.
Question: I’ve seen references to “pharyngitis” and haven t been able to figure out what it is. My dictionary says it’s inflammation of the pharynx, which is “the part of the vertebrate alimentary canal between the cavity of the mouth and the esophagus.” Please translate.
Answer: It’s a sore throat.
Question: A few months ago I developed “thrush”—whitish patches on my tongue and on the back of my throat—after a six-day course of intravenous antibiotics. The antibiotics apparently killed the normal protective bacteria in my mouth, allowing the thrush to develop. Now I’m concerned about my intestinal bacteria as well. So I’ve been taking L. acidophilus and bifidus supplements to reestablish those bacteria. Is that the right thing to do?
Answer: No. The bacterial imbalance that follows use of antibiotics may indeed allow other bacteria or fungi to take hold. Those include the Candida that cause thrush. But the “intestinal flora” supplements you mention have never been shown to help prevent or treat that imbalance. You should treat the Candida with an effective antifungal medicine, such as oral nystatin (Mycostatin). The usual bacterial population will return to your mouth and intestinal tract on its own.
AGING: HARD TO SWALLOW
Question: Older people often seem to choke on food, cough a lot while eating, or swallow “the wrong way\ ” What are the cause and treatment for those reflexes?
Answer: As people age, the muscles in the back of the throat and upper esophagus, which are responsible for swallowing, often become less well coordinated. Most older people don’t notice that gradual change unless it’s compounded by other factors—for instance, poor chewing due to problems with teeth or dentures, or eating or drinking too rapidly.
To help prevent choking, try to chew food well, swallow carefully, and eat in an upright position. If you wear dentures, make sure they fit properly.
Question: I have esophageal achalasia, which makes swallowing extremely difficult. Other than eating finely chopped food or chewing food thoroughly, is surgery the only way to correct my problem?
Answer: No. Only about one out of four patients eventually requires surgery. In achalasia, the muscular ring, or sphincter, between the esophagus and the stomach fails to open adequately when you swallow. Treatment depends on the severity of the condition, which is determined by taking X-rays and examining the esophagus through an endoscope, a flexible lighted tube. (Since achalasia may increase the risk of esophageal cancer, endoscopy checks for that possibility as well.)
There are two nonsurgical alternatives. Medications such as nifedipine (Procardia) may relax the sphincter. If not, a special instrument can be passed down the throat to widen the sphincter by splitting the constricting muscle fibers.
RASH IN THE MOUTH
Question: What can you tell me about oral lichen planus? Is there a treatment?
Answer: Lichen planus is a common disease that appears in the mouth, on the skin, or both. The oral version often shows up as a lacelike network of white lines located on the inside of the cheeks. The disease can also take the form of open sores on the gums, tongue, palate, floor of the mouth, or lips. Those sores can cause bleeding and pain and hamper proper dental care. At its worst, the inflammation can even interfere with eating, swallowing, and speaking. People in their 40s and 50s are more prone to lichen planus than other age groups, and the cause has never been identified.
Treatment for oral lichen planus depends on the severity of the disease. If you have only the white lacy lines, no treatment may be necessary, since those lines cause no other symptoms. For those who have sores, treatment frequently consists of a corticosteroid paste (Kenalog) or gel (Lidex, Temovate). Though treatment is often effective at promoting healing, the disease can often recur over several years. The antifungal oral rinse nystatin (Mycostatin, Nilstat, Nystex) is often prescribed along with corticosteroids, since individuals who have lichen planus are at increased risk of oral yeast infections, and corticosteroids boost that risk even further.
Severe lichen planus can sometimes be the first sign of an undiagnosed case of hepatitis C, so individuals with severe symptoms should also be screened for the hepatitis C virus. People with oral lichen planus are at higher risk of squamouscell carcinoma and should have their mouths checked for cancer at least once a year.
Question: Recently I noticed a white film on my tongue that I cant seem to remove by brushing. Any suggestions?
Answer: First, try to track down the cause of your coated tongue. Sometimes it’s a change in diet. If so, try eliminating the suspected offender; and see if the coating disappears. Ask your physician whether the culprit could be a yeast infection or medication you have taken—particularly antibiotics and medications that dry the mouth, such as antihistamines.
When the cause can’t be determined or corrected, brushing the tongue with a soft-bristle toothbrush does help some people. Since that didn’t help you, you might simply try drinking more fluids. In time, the condition will probably disappear on its own.
EAT AND RUN
Question: Why does my nose run while I’m eating or after I eat? It happens with all types of foods, and mainly after dinner.
Answer: You’re experiencing what’s called prandial rhinorrhea, meaning—sure enough—the free discharge of a thin nasal mucus, associated with a meal. Eating activates the autonomic nervous system, which releases the chemical acetylcholine. That in turn gets the body’s juices flowing, including saliva and stomach acid as well as nasal mucus and sometimes tears. The degree of reaction varies widely. Usually, the spicier the meal, the greater the reaction.
If your problem is severe, try taking an antihistamine or a decongestant before you eat. If that doesn’t do the trick, consult your physician.
Health handbook introducing you to read the article: NOSE, MOUTH, AND THROAT DISORDERS
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