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Tummy troubles: disorders of the mouth, tongue and lips TUMMY TROUBLES: DISORDERS OF THE MOUTH, TONGUE AND LIPS
Q. The mouth, tongue and lips are very obvious parts of the body, both because they are readily visible and also because they have an enormous nerve supply which makes disorders here fairly uncomfortable. At least this is fortunate for it brings it to the attention and increases the chances of seeking proper medical help. What are some of the more common problems in this area?
A. There are several which are worth discussing. First let's talk about cold sores, these have been in the news for the past few years and affect nearly everybody. Cold sores are also known as herpes simplex and appear in the form of multiple tiny blisters. Herpes simplex may occur on the lips but is more common in the area surrounding them. It is caused by a virus HSV-1 and sometimes this can rapidly spread and become a serious disease necessitating urgent medical attention.
Q. What about treatment?
A. A new antibiotic called acyclovir, which will soon become available in Australia, is said to be curative. Apart from this the application of ice to the sores, ideally before the blister appears, for about 60 minutes often helps. This is called cryotherapy ( = cold treatment). The drug idoxuridine ('Stoxil') may help if applied very early before blister formation, and another called poridone iodine ('Stoxine') may help. Otherwise, simple methylated spirits applied every hour and antiseptic are about all that is left. Avoid too much sunshine or foods to which you are allergic.
Q. Some people seem to suffer from a horrible looking black tongue.
A. A dark brown to black coating can occur on the surface of the tongue. It is common after treatment with antibiotics and merely means that the superficial layers of cells on the tongue are not being shed (desquamated) as they normally are. It disappears without treatment soon after the course of antibiotics has been completed.
Rinsing with hot, salty water (1 tsp salt in glass of hot water) 3-4 times a day assists if the condition feels unpleasant and unhygienic.
Q. What causes little clear coloured lumps to occur inside the lips. Quite a few people seem to develop these.
A. These are called mucous cysts or mucocoeles.
These usually occur as a single, simple swelling on the inner side
of the lip the shape of a pea. It may gradually increase in size and is due to a blockage of a mucous gland. Sometimes a swelling of a blood vessel in this area can simulate a mucous cyst. If the cyst is proving troublesome (such as when eating) it may be removed surgically by the doctor. It is excised (often under local anaesthetic) and sutured or the base diathermied to check bleeding. Because of the copious blood supply to the mouth, tongue and lips, bleeding can sometimes be profuse but this is readily checked during any surgical operation.
Q. I guess many mothers have to cope with a facial injury when her child happens to sustain a fall.
A. Injuries to the tongue, lips and mouth are common. A very common injury is with children who slip from scooters and wheeled toys onto a hard surface. A tooth is commonly forced through the tongue or lip. With any injury in this region bleeding is usually profuse. It indicates that a vast network of blood vessels exists to bring blood to this region. In most instances, simple cleansing of the injured part with cool water, plus pressure (e.g. with a fabric pad, such as a handkerchief or gauze swab) for 10-15 minutes will usually check this. Deeper wounds may need suturing (stitching) by the doctor. Any dirty wound (on any part of the body) needs an anti-tetanus injection. The doctor usually does this automatically. With the widespread use of immunisations from an early age, many children and adults are already protected against tetanus. But a "booster shot" may be required if none has been received in recent years.
Q. Are many people troubled with foreign bodies in this part of the system?
A. Yes. One of the most common is a fish bone which can easily become stuck in a large protruding tonsil. Alternatively it may become lodged in the throat or in any part of the oral cavity. Removal is essential. Often it may be seen without difficulty and, with a little dexterity, simply removed. No further treatment is required. Professional help is sometimes needed if it is hard to find or remove.
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