I have a vaginal rash and mouth ulcer. Could they be related?

Dr Flo,
I have been to several doctors because of a mouth ulcer on one lip. I get treatment and the ulcer disappears only to come back after a few months. I also have hyperacidity. In addition to this, I have a vaginal rash and severe itch. I have been to three different gynaecologists and had pap smears, but nothing was found. I was given yeast infection medication, which only helped for a while. I try to eat clean and make sure I eat fruits and vegetables in every meal because I have had health issues since childhood. Could the mouth ulcer and vaginal rash be related? How best can I treat the two once and for all or which doctor should I see?
Jo

Dear Jo,
You most likely have an aphthous ulcer on the lip, otherwise known as canker sores. In most cases, there is no known cause for aphthous ulcers. They may appear when you bite yourself, when you are stressed, if you do not sleep or eat well, if you lose weight too fast, if you take acidic foods or drinks or have hyperacidity, if your immunity is lower like when you have a cold, or there are hormonal changes, or even from bacterial, fungal or viral infection. It may also be from vitamin B12 or folate deficiency. Some people are genetically predisposed to having the sores, and this may be a result of an auto-immune disease. In an auto-immune illness, the body’s immune system forms antibodies against some tissues in your own body, in this case, against your mucous membranes. You may benefit from screening for vitamin B12 and folate deficiency and for auto-immune illnesses like Behcet’s, crohn’s disease and lupus.

You cannot completely eradicate the apthous ulcer since by nature, it is recurrent. To manage it, gargle with some salty water or mouth wash, use some topical creams to relieve the pain and inflammation, and use anti-viral medication for cold sores, if you have them. Avoid very hot food or drinks, and avoid very salty, spicy or acidic foods. Take a lot of water, manage the hyperacidity and have good dental care. Vitamin B and folic acid supplements may also be of help. If a sore lasts for more than two weeks without healing, you need to be reviewed by a doctor.
It is normal for all women after puberty to have a vaginal discharge. It is a mixture of fluid and cells that help to keep the vagina clean and moist and to prevent infection. The appearance changes depending on the menstrual cycle, and can also be affected by exercise, stress, use of hormonal medication and sexual arousal. The discharge may vary from white to clear, and from watery to thick, at different times of the cycle. It is also normal to have a brown or bloody discharge just before, during or after your periods, or sometimes in between your periods (spotting).
If there is abnormal colour (yellow, green, sometimes white), itching, a foul smell, or thick, chunky discharge, then most likely there is a vaginal infection. The infection may be caused by fungi, bacteria or other organisms. An infection may also cause pain when passing urine or pain during intercourse. Because of the recurrence, you should have a high vaginal swab (HVS) and culture done to see if there is infection or the discharge is normal. If it is established to be candidiasis, you can be put on antifungals for several consecutive months to prevent recurrence. Any other infection will be treated appropriately. A pap smear may not be very helpful in this case since it specifically checks for cancer of the cervix.
For some people, there is no identifiable reason for recurrence of candidiasis; however, it may occur due to having a low immunity, or diabetes or long-term use of steroid medication. Any infection can be transmitted, though it is not common to transmit candidiasis from a female to a male partner. Candidia infection on the penis can be easily treated using a topical cream.
 

Dr Flo,
My stomach is always full of gas and it usually rumbles. It also looks bigger. What could be the problem?
Jonathan

Dear Jonathan,
Having a lot of gas in the abdomen is also referred to as bloating. The gas is what produces the noises and makes your stomach look big. It can also cause persistent belching and abdominal pain.
About half of the gas in our digestive systems comes from swallowed air, and the rest is usually produced by the bacteria in the gastrointestinal system that helps to digest food. If the food does not move through the intestines as it should, then there can be a buildup of gas. You can also get a buildup of gas if you eat too quickly, too much or when you eat fatty foods. You can also build up gas by drinking through a straw, chewing gum, sucking sweets and taking carbonated drinks like soda.
Some foods also increase the amount of gas in your intestines such as beans, lentils, whole grains, some vegetables (cabbage, cauliflower and carrots), some fruits, artificial sweeteners, and dairy products, if your body has difficulty digesting milk and milk products. Smoking has also been associated with bloating.
Some diseases can also cause recurrent bloating including hyperacidity, constipation, irritable bowel syndrome, functional gastrointestinal disorders, infections, food intolerance (for example lactose or gluten intolerance), side effects of some medicine, hormonal changes, especially in women; excessive weight gain, eating disorders, stress, depression and anxiety; blockage of the intestines, impaired movement of the intestinal muscles, diseases of the pancreas, accumulation of fluid in the abdomen (ascites) due to other illnesses like kidney disease, liver disease, heart failure and cancer.
To manage the bloating, avoid chewing gum and using drinking straws, eat slowly, avoid gassy foods, stop smoking, avoid carbonated drinks, and if you are lactose or gluten intolerant, avoid those foods. Some medicine help with the symptoms of bloating like simethicone, probiotics, anti-spasmodic medication and some anti-depressants. Since you have had the problem for some time now, it would be advisable to get a proper check up, preferably by a gastroenterologist (stomach specialist), so that if there is any underlying problem it can be addressed.

Send your medical questions to [email protected] for free expert advice