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DR ELLIE reveals what a white furry tongue really means for your health
Thrush is the most common cause of white patches in the mouth, but other conditions should be considered too.
Known as an opportunistic infection, thrush usually affects those with a weakened immune system, such as older people, those on immunosuppressant drugs and pregnant women.
The fungal infection is also frequently seen in babies.
It usually affects the mouth or genitals, causing a white coating or patches. This can be very sore.
An anti-fungal treatment is often prescribed, often nystatin drops or fluconazole tablets.
Thrush is the most common cause of white patches in the mouth and usually affects those with a weakened immune system
If a patient does not respond to treatment or tests negative for thrush, it is essential doctors explore other causes. One is leukoplakia – white patches that often develop in the mouths of heavy smokers or drinkers.
Leukoplakia can, in some cases, lead to mouth cancer, so it's vital that a hospital appointment is arranged with a specialist.
Another trigger might be oral lichen planus, painful white patches on the gum, tongue and the inside of the cheeks.
The exact cause is unknown, but it can happen after a mouth injury, allergies or taking certain medicines.
It can take up to a year or longer to clear up, and there is no treatment. However, a GP can prescribe mouthwashes and sprays to combat the pain.
Patients with oral lichen planus are advised to avoid salt, spicy and acidic foods, plus alcohol.
I'M 85 years old and have terrible right shoulder pain, which keeps me awake. I'm told this is due to arthritis in my rotator cuff.
Do you have any advice?
Shoulder pain is awful, but there are a several ways to manage the problem.
For older people, the rotator cuff can be the source. It's a group of a muscles surrounding the shoulder joint, providing it with flexibility and stability.
Over time, the rotator cuff can become worn-down or osteoarthritis may develop. Either can cause pain and stiffness in the joint and does not go away.
The pain is known to keep patients up at night, which can lead to fatigue, and raise the risk of dangerous falls.
The first step to managing rotator cuff pain is physiotherapy – exercises and stretches that can improve mobility and reduce pain in the joint.
A GP can refer patients in pain to see a physiotherapist or, in some parts of the country, people can contact an NHS physiotherapy unit for an appointment without a referral.
There are also a number of prescribed drugs you can get from a GP or a pharmacist to help manage the pain.
Amitriptyline tablets, which are taken at night can help people with chronic pain to sleep. A low dose of the opioid codeine is another option.
However, codeine can trigger side effects, such as confusion, dizziness and drowsiness, so it's important patients discuss its use with a GP.
MY ulcerative colitis was under control for 12 years, until I began taking antibiotics for a bladder infection this year.
I've had a terrible flare-up, which doctors said is a common side-effect of the tablets.
Why was I given them then?
An extended course of antibiotics is known to trigger bowel disease flare-ups. Sadly, there is sometimes no other option.
Antibiotics destroy the bacteria causing infections. However, the tablets can also disrupt the 'good' bacteria in the gut, which keep the intestines healthy.
As a result, underlying inflammatory bowel diseases like ulcerative colitis and Crohn's can worsen. Sufferers can experience stomach aches, bloody diarrhoea and fatigue.
Ulcerative colitis affects the colon and rectum. Crohn's can occur anywhere involved in the digestive process, including the mouth and anus.
Their cause is unclear, but are considered autoimmune diseases, where the immune system attacks healthy tissue.
Neither can be cured, but certain medicines and surgical procedures can reduce flare-ups.
When someone takes a six-month course of antibiotics to tackle a recurrent UTI, the dose is usually low enough to limit the risk of bowel flare-ups.
Other treatments include probiotics – pills containing good bacteria – which can reduce the recurrence of UTIs. Antiseptic treatment, Hiprex sterilises bacteria in the urine. However, antibiotics are the most effective treatment for bacterial infections, so bowel patients will be given them still.
To reduce the risk of further UTIs, it might be worth considering if the infections are triggered by other factors.
An inability to empty the bladder fully or an overactive bladder can raise the risk. Both can be managed with medicines – not antibiotics – which your GP can prescribe.
Vile cancer premiums on loans
I was concerned to hear last week that as many as half-a-million Britons are being penalised when buying insurance, mortgages and other financial services because they have survived cancer.
In many cases, former patients have been made to pay higher premiums or are even outright refused loans or insurance – despite the fact that they are now healthy, a study carried out by Queen's University Belfast has found.
I think this is shocking behaviour from these financial firms.
A number of European countries, France for instance, have laws which ban this kind of discrimination – but not the UK. Perhaps it's time the Government changed this.
Is this something that has happened to you? Please write in using the email address to the right and let me know your thoughts.
Graham proves mental issues can hit any man
I was terribly sad to hear about the suicide of England cricketing legend Graham Thorpe.
Following the news, I did a BBC radio phone-in discussion about men's mental health. We know that men are less likely to seek help for mental illness than women, as well as have a higher rate of suicide.
England cricketing legend Graham Thorpe took his own life
However, I was taken aback during the show by the sheer number of successful men, with good jobs and happy families, who called in to talk about their depression. Many said they had been too embarrassed to seek help.
In the past few years there has been a concerted effort to improve discussions around men's mental health, but I fear we still have a long way to go.
Why do you think so many men are resistant to mental health help? Write in to the email below and tell me.