Is my cracked tongue a cause for concern?

Dear Doctor,

My tongue is cracked but not painful. When I consume tomatoes, salt, citric fruits and juice there's a burning sensation. I'm scared when in public and my lips are dry because licking them will make people see my tongue. Note: this is from childhood and I am now 26. My younger brother has the same problem, too.  When I visited a clinician, I was advised to use mouth wash, and it used to cause that burning sensation so I stopped. Kindly help me understand my problem.

Dear reader,

About one in 20 people have a cracked or fissured tongue, also known as lingua plicata. This means that you have one or more shallow cracks on the top surface of your tongue. There is no known cause for a fissured tongue, but it is thought to be hereditary. It may also occur alongside other disorders.

Having a fissured tongue is not harmful, but it also cannot be cured. The condition is usually painless though some people experience a burning sensation when they take acidic food or drinks. Also, debris can accumulate in the cracks leading to inflammation or infection, which can cause pain and irritation on the tongue, so it is advisable to clean the tongue using a brush and a tongue scraper. In case of infection, treatment specific to the type of infection can be administered.

Dear Dr Flo,

I am a 63-year-old man. My problem is that whenever I visit the toilet, I try and pass all the urine, but some drops still come out later when I am zipping my pants, and I end up smelling the whole day. What could be the problem?

Wanjala

Dear Wanjala,

What you are experiencing is called post-void or post-micturition dribbling, or after-dribbling. If it’s only a few drops for one or two minutes, then it is normal. If it goes on for longer than that, or if the amount is more than just a few drops, then it is a problem. It usually occurs when the muscles around the urethra (the tube that carries urine from the bladder) do not contract properly, and therefore the urethra does not completely empty. This can also cause the bladder not to empty fully.

There are several issues that may be associated with after-dribbling, for example, diseases of the prostate, urinary tract problems, some medications, nerve problems, among others. If you have any additional problems like problem initiating urination, pain or burning sensation when passing urine, blood in urine, frequent urination, feeling like the bladder is not fully emptied, straining to pass urine, urine passing out slowly or feeling the need to urgently pass urine, then you need a prostate check with the doctor.

There are several things you can do to help the situation:

- Sit down on the toilet seat when passing urine

- Take your time and don’t be in a hurry to complete urination

- Pull down your trousers and underwear properly

- Push gently on the scrotum upwards and forwards to encourage the flow of urine along the urethra

- Press on the perineum (the area just behind the scrotum) to help remove any remaining urine from the urethra once you are done

- Kegel exercises to strengthen the pelvic muscles. To identify the pelvic muscles, try to stop the flow of urine by clenching your muscles when you are halfway through passing urine. The muscles that you need to do that are the pelvic floor muscles. You need to repeatedly contract and relax these muscles for several minutes, multiple times a day.

Dear Healthy Nation,

My son is four years old and since he started kindergarten last year, we noticed that he was more hyperactive than the other children in his class. He was like that even before, but we thought it was just normal toddler behaviour. He is not doing very well in his class work and he also seems to forget what he is told very quickly. What can we do?

Concerned parent

Dear concerned parent,

Your child may be suffering from Attention Deficit Hyperactivity disorder. It is a behavioural disorder with symptoms like being easily distracted, difficulty focusing on one task, forgetting easily, getting bored easily, problems learning a new thing, getting confused easily, problems following instructions, day dreaming, fidgeting, talking and moving around very fast, constantly moving, difficulty playing or doing tasks quietly, impatience, interrupting conversations, acting or speaking without restraint and blurting out comments.

All these are normal to some extent, but it is considered a disorder if it is interfering with how the child is doing at school, and how the child interacts with others.

In some instances, this disorder may also occur together with learning disorders, conduct disorders, and even poor social interaction. In the older children and adults, it may also occur together with anxiety, depression and substance abuse.

The symptoms usually become more obvious when the child’s circumstances change for instance when they start school or when they change schools. In about half of all those with the disorder, the symptoms improve with age as the child learns how to control their behavior more.

There are no known causes of ADHD, but it has been associated with genetics (if someone has it, there is a likelihood that a close blood relative also has it), low birth weight, alcohol or substance abuse during pregnancy, exposure to environmental toxins like lead during pregnancy or early childhood.

The disorder can be managed when diagnosed. Care may involve a paediatrician, a psychiatrist, a psychologist or all three. Usually an assessment is done first, involving also a report from the school. If a diagnosis of ADHD is made, the child may be put on medication to help reduce the hyperactivity. You will also be advised on how you and the teachers can also assist in managing the child’s behaviour. As the child grows older, he will also be involved in the behavior modification. About half of all children with ADHD are able to manage the symptoms well enough that they have minimal or no symptoms by the time they are adults.

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