DR. ELLIE Reveals What a White, Hairy Tongue Really Means for Your Health

Thrush is the most common cause of white spots in the mouth, but there are other conditions to consider.

Thrush is an opportunistic infection and mainly occurs in people with weakened immune systems, such as the elderly, people taking immunosuppressive drugs and pregnant women.

The fungal infection is also common in babies.

It usually affects the mouth or genitals, causing a white coating or patches. This can be very painful.

Antifungal treatment is often prescribed, often nystatin drops or fluconazole tablets.

If a patient does not respond to treatment or tests negative for thrush, it is essential that doctors investigate other causes. One of these is leukoplakia – white patches that often develop in the mouths of heavy smokers or drinkers.

Leukoplakia can in some cases lead to oral cancer. That is why it is important to make an appointment with a specialist at the hospital.

Another trigger can be oral lichen planus: painful white patches on the gums, tongue and inside the cheeks.

The exact cause is unknown, but it can develop after an injury to the mouth, allergies, or the use of certain medications.

It can take a year or more to go away and there is no treatment, but a GP can prescribe mouthwashes and sprays to help with the pain.

Patients with oral lichen planus are advised to avoid salty, spicy and acidic foods and alcohol.

I am 85 years old and have terrible pain in my right shoulder which keeps me awake. I have been told this is due to arthritis in my rotator cuff.

Do you have any advice?

Shoulder pain is horrible, but there are several ways to treat the problem.

For older people, the rotator cuff may be the source. It is a group of muscles that surround the shoulder joint and give it flexibility and stability.

Over time, the rotator cuff can become worn or osteoarthritis can develop. Both can cause pain and stiffness in the joint and do not go away.

The pain is known to keep patients awake at night, which can lead to fatigue and an increased risk of dangerous falls.

The first step in treating rotator cuff pain is physical therapy: exercises and stretches that can improve mobility and reduce pain in the joint.

A GP can refer patients with pain to a physiotherapist. In some parts of the country, people can also contact an NHS physiotherapy department for an appointment without a referral.

There are also a number of prescription medications that you can get from your GP or pharmacist to help relieve the pain.

Amitriptyline tablets, taken in the evening, can help people with chronic pain sleep. A low dose of the opioid codeine is another option.

However, codeine can cause side effects such as confusion, dizziness and drowsiness, so it is important that patients discuss its use with their GP.

My ulcerative colitis was under control for 12 years until I started taking antibiotics for a bladder infection this year.

I had a terrible attack, which doctors say is a common side effect of the tablets.

Then why did I get them?

It is known that prolonged antibiotic treatment can cause flare-ups of bowel disease. Unfortunately, sometimes there is no other option.

Antibiotics destroy the bacteria that cause infections. However, the tablets can also disrupt the ‘good’ bacteria in the gut, which keep the gut healthy.

As a result, underlying inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease may worsen. Patients may experience stomach pain, bloody diarrhea, and fatigue.

Ulcerative colitis affects the colon and rectum. Crohn’s disease can occur anywhere the digestive process takes place, including the mouth and anus.

The cause is unclear, but they involve autoimmune diseases, in which the immune system attacks healthy tissue.

Neither condition can be cured, but certain medications and surgical procedures can reduce flare-ups.

When someone needs to take antibiotics for six months to treat a recurring UTI, the dose is usually low enough to limit the risk of bowel problems.

Other treatments include probiotics – pills containing good bacteria – which can reduce the recurrence of UTIs. Antiseptic treatment, Hiprex sterilizes bacteria in the urine. However, antibiotics are the most effective treatment for bacterial infections, so intestinal patients still get them.

To reduce the risk of further UTIs, it may be useful to consider whether the infections are caused by other factors.

The inability to empty the bladder completely or an overactive bladder can increase the risk. Both can be treated with medications – not antibiotics – that your doctor can prescribe.

Vile cancer premiums on loans

I was concerned when I heard last week that as many as half a million Britons are being penalised for taking out insurance, mortgages and other financial services because they are cancer survivors.

A study by Queen’s University Belfast found that former patients in many cases are being charged higher premiums or even denied loans or insurance altogether, despite now being healthy.

I find this behavior from these financial companies shocking.

Some European countries, France for example, have laws that prohibit this kind of discrimination – but the UK does not. Perhaps it is time for the government to change this.

If this has happened to you, please write using the email address on the right and let me know what you think.

Graham proves that mental health issues can affect any man

I was deeply saddened to hear of the suicide of England cricket legend Graham Thorpe.

After the news I did a BBC radio talk about men’s mental health. We know that men are less likely to seek help for mental health issues than women, and that they have a higher risk of suicide.

However, I was surprised during the show by the number of successful men, with good jobs and happy families, who called in to talk about their depression. Many said they had felt too ashamed to seek help.

In recent years, there has been a lot of effort to improve the conversation around men’s mental health, but I fear we are still a long way off.

Why do you think so many men are resistant to mental health help? Write to the email address below and tell me.