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Chronic painful white tongue with ulcers
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MichelleAbcs posted:
I am SO frustrated. I have had a white tongue with sores in my mouth almost 5 months now. My stomach is upset and I have very little appetite. I have seen a GI doctor and they have ruled out Cancers. I have been treated for "thrush" multiple times and it gets some better but never goes away. I am at the point of eating primarily Activia yogurt. I am totally fatigued and just this week started having jaw pain. Arrgh.

I have no idea what it is. I originally thought fungus or yeast but it doesn't go away with treatment.

It has been going on for 5 months and is terribly painful. Pain is baseline at a 6 and has times when it is an 8.

The symptoms primarily are seen on my tongue but I do have an upset stomach, throat pain, fatigue and now jaw pain.

The white part along with the sores cover the majority of my tongue.
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Gwen Cohen Brown, DDS, FAAOMP responded:
Hi MichelleAbcs,

Although I cannot diagnose online your post seems to be describing a condition known as Geographic Tongue also known as Benign Migratory Glossitis.?

Clinically this presents as smooth red circles with white raised halos on the top surface of the tongue. It is symmetric, the right and left sides of the tongue look similar, and the lateral borders (sides) and tip of the tongue are often affected as well. We do not know why it happens but there is a genetic component to it so if you can ask your parents and siblings to look at their tongues as well. Geographic tongue is very common and is seen in approximately 14% of the population overall.

If you look at the surface of the tongue it is normally covered with hundreds of tiny little hairlike projections. These are filliform papilla and they are made of keratin like your hair. The purpose of the filliform papilla is to protect the surface of the tongue. In patients wirh Geographic Tongue the filliform papilla come off leaving a red patch visible on the tongue. ?Don't worry though they will grow back, only to fall off somewhere else on the tongue. That is why it is called geographic tongue, it moves! It is not speading it is just happening somewhere else.

It is often clinically misdiagnosed as an oral yeast infection, or candidiasis. Remember though, candida is a normal part of the oral flora, it is supposed to be there. Patients with geographic tongue temporarily lose patches (circles) of filliform papilla leaving the tongue unprotected so those red spots can become quite sensitive often feeling like they are burning.?

The normal candia organisms - the ones that live in your mouth and are supposed to be present - can superficially invade the surface of the tongue when the filliform papilla are not present resulting in a superficial candida infection. This is why anti-fungal medication can provide temporary relief. It is only temporary though as fungal organisms are supposed to be in your mouth and they will come back.?If you, or anyone you know, has ever had a vaginal yeast infection the signs and symptoms of an oral yeast infection are quite similar, burning, itching and pain. Add to the mix any acidic, spicy, or hot temperature foods and you can understand why geographic tongue has the potential to be quite uncomfortable.?

So the question is this, if you do have geographic tongue why has it gone from being a nuisance to being a chronic pain problem. Sometimes knowing what it is will help, it decreases the anxiety associated with not knowing, it also answers the question is it something I need to worry about like cancer (which it is not).??

You should look at some photos of geographic tongue and then speak with your dentist or physician to confirm the diagnosis. If you are still concerned consider speaking with a specialist in oral pathology or neuropathology who can explain the condition in more detail and work with you on decreasing the pain. Anxiety and stress detailing with a chronic pain condition can result in other symptoms as well including upset stomach and jaw pain.

I hope you feel better soon and that this helps.

Dr. Gwen Cohen Brown
 
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ashler responded:
Michelle, did you solve your problems? what tests did you have?

does your tongue looks like this?

http://d2h6mj3zl2uk5d.cloudfront.net/cdn/1368808963/medhelp_images/user_photos/419526?1368808963

(this is how my tongue looks like since 12 months ago)


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