DEAR DR. DONOHUE: I have burning tongue syndrome. At times, it is almost unbearable. The only thing that helps somewhat is a saltwater mouth rinse. My dentist, my internist and a neurologist haven’t offered any relief.

I also get sores in my mouth and on my tongue. Any insight? – P.H.


ANSWER: Burning tongue syndrome is also known as burning mouth syndrome because the gums, roof of the mouth and lips also can feel like they are on fire. It happens mostly, but not exclusively, to women after menopause. Although painful and disturbing, it’s not a health threat. No one knows the exact cause, but it might be that nerves serving the tongue and mouth are malfunctioning.

Let me give you a few home remedies for it: rinsing the mouth with cold apple juice; and combining equal parts Benadryl elixir and Kaopectate as a mouthwash. Don’t swallow these rinses, and use them four times a day. Another remedy is six drops of hot pepper sauce (Tabasco sauce) in a teaspoon of water and swishing it around in the mouth four times daily. It might increase the burning at first, but after a day or so it should lessen it. If it doesn’t, abandon it.

Don’t eat or drink spicy or acidic foods or beverages. Don’t use mouthwashes with alcohol in them. Change your toothpaste brand. Chew sugarless gum.

When burning mouth fails to respond to the above, the medicines Klonopin, Elavil or Neurontin might help.

Have your doctors looked for things like dry mouth, B vitamin deficiencies, anemia, diabetes, lichen planus, thyroid problems and Sjogren’s syndrome?

Sores on the tongue and in the mouth are not ordinarily a part of burning tongue syndrome. Get to a doctor when the sores are present. You might have recurrent canker sores and not burning mouth syndrome.

DEAR DR. DONOHUE: Will you please define claudication? Is there any treatment for it? – R.L.

ANSWER: Claudication is leg pain that comes on with activity and is due to clogged leg arteries. Depending on where the clog is, the pain can be felt in the buttocks, the hips, the thighs or the calves. The medical name of this condition is peripheral artery (or vascular) disease.

Quite often, pain arises in the calves. Affected people have an uncanny ability to predict how far they can walk before they have to stop because of pain. Resting relieves the pain, and walking can then resume.

Plenty can be done for it. Medicines can sometimes keep the pain from developing. Another way to attack claudication is to open the clogged artery with a balloon-tipped, slender, pliable tube (catheter), just as they do for clogged heart arteries. Or the same kind of heart artery operation in which grafts replace the obstructed artery can be done for leg arteries.

The booklet on peripheral artery disease explains this illness and its treatment. Readers can obtain a copy by writing: Dr. Donohue – No. 109, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Several months ago, I was in the doctor’s office for a regular checkup. Eventually someone called “Robert” and I answered the summons and was ushered into a room with test equipment. Some kind of electrocardiac procedure was done, and the technician said, “That’s it.” I left. The following Monday, I got a call from the doctor’s office asking if I had been in the previous Friday and did I have whatever the test was. I said I had been there. She said that the test was for another Robert, and we had to reschedule an appointment.

I know most of the personnel in that office, but this technician was a new one to me, and I think it would have been wise to make sure who the patient was. – R.P.


ANSWER: Now, that is weird. You didn’t pay for the visit or the test, did you?

DEAR DR. DONOHUE: Please explain ileus. What causes it, and how can it be prevented? I have had two recent surgeries: heart bypass and knee replacement. Immediately after each, I suffered from an ileus. The recovery from that was worse than the recovery from the surgery.

I have had other surgeries without a problem. I am faced with further surgery in the future, and the thought of the misery and discomfort of the post-surgery recovery with a tube in my nose makes me reluctant to have another operation. Is there a way to prevent this from happening? – D.B.

ANSWER:
Ileus is an intestinal tract shutdown. When all is working well, muscles that encircle the intestine contract to push the intestinal contents downward and eventually outward. If those muscles stop contracting, the tract fills with gas, and the bloating produces severe abdominal pain. Surgeons question their post-op patients daily about passing gas or having a bowel movement. Their questioning is so incessant that patients often feel obligated to send out official notifications of these events when they occur, to family and friends. The surgeons are worried about an ileus, the treatment of which consists of decompressing the intestinal tract through a long tube passed through the nose and into the stomach.

Major contributors to ileus are drugs like morphine or Demerol, which are used to control surgical pain. Sometimes an imbalance of sodium, potassium and chloride brings it on. When scheduled for another procedure, tell the surgeon what happened to you; perhaps a change in painkillers can avoid another encounter with ileus.

Ileus often happens after abdominal surgery, when the intestine has to be manipulated. That’s a different issue. The literal meaning of “ileus” is “obstruction.”

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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