This is termed Recurrent aphthous stomatitis, which is not an uncommon condition in her age group. The cause is usually not determinable and the following are the predisposing factors;
1) Deficiency of iron, folic acid (folate), or vitamin B.
3) Food allergies
4) Helicobacter pylori which cause stomach ulcer may be associated.
5) Decreased body resistance (immunity).
6) Foods, particularly chocolate, coffee, peanuts, eggs, cereals, almonds, strawberries, cheese, and tomatoes
Treatment of it is following;
The treatment consists of a multi-point approach, consisting of the following:
1. Tetracyclin in the form of mouth swish or expectorate. This is effective for its antibacterial action.
2. Topical anesthetic in the form of a Benzocaine paste. This helps to numb the pain temporarily.
3. A topical steroid gel containing Triamcinolone Acetonide. This helps to reduce inflammation.
4. A 2-3 weeks course of vitamin B complex capsules. This helps to correct any nutritional deficiencies.
Hematinic (iron, folic acid, vitamins B-6 and B-12) deficiencies are twice as common in patients with recurrent aphthous ulcers. At present, no single theory of the immunopathogenesis of recurrent aphthous ulcers exists, but immune dysregulation may play a significant role. Thus you may ask his doctor to get the following work up too;
1) Determination of iron, ferritin, folate, and vitamin B-6 and B-12 levels.
2) Antinuclear antibody.
3) Patch or sensitivity testing.
4) Biopsy with hematoxylin and eosin stain and cultures.
These should be able to point to the cause and will be able to prevent the episodes and chalk out the right treatment. Meanwhile, the following also would be advised;
1) Avoidance of salt and hot spices to prevent pain.
2) Some people may correlate the appearance of ulcers after exposure to walnuts, pineapple, cinnamon, or other agents. In such cases, remission may be achieved by avoiding the inciting agent. If food exposure is thought to be the culprit, a food diary can be helpful.
3) Medications like Colchicine and Montelukast sodium are efficacious (prescription medicines).
4) Gelclair can provide a protective coating to reduce pain.
I hope your symptoms resolve soon.
I would be happy to assist you further if you need any more information.
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