A dry mouth needs in­ves­ti­ga­tion

The Weekend Australian - Travel - - Health -

I have suf­fered for months from a dry mouth. I seem to have very lit­tle saliva. I was tested for Sjo­gren’s syn­drome, but that proved neg­a­tive and at the time the prob­lem de­vel­oped I was not tak­ing any med­i­ca­tion. What could have caused this? UN­FOR­TU­NATELY, dry mouth, or xe­ros­to­mia, is quite com­mon, af­fect­ing about one in four Aus­tralians. You ap­pear to have ruled out two of the more com­mon causes for the sali­vary glands not pro­duc­ing the stan­dard 1.5 litres of saliva a day. With re­gard to med­i­ca­tions, did you con­sider over-the­counter reme­dies? Some of th­ese, such as anti-his­tamines and anal­gesics, can also cause dry mouth. If this is also neg­a­tive, there is a range of pos­si­ble causes to ex­plain your symp­toms. It could be some­thing rel­a­tively sim­ple, such as a chron­i­cally blocked nose which causes you to breathe through your mouth, thereby dry­ing it out. At the other end of the spec­trum, it could be re­lated to some­thing more com­plex, such as un­der­ly­ing di­a­betes or Parkin­son’s dis­ease. You need to dis­cuss this with your doc­tor and be in­ves­ti­gated fur­ther, be­cause as well as be­ing un­com­fort­able, a dry mouth also presents a den­tal hy­giene risk, in­creas­ing the like­li­hood of mouth in­fec­tions and tooth de­cay. I am­n­early re­cov­ered from a se­ri­ous bout of cold/flu. I just have a cou­ple of ques­tions. Why don’t we cough when we’re asleep? Why has no pre­ven­tion or cure been found for colds and flu? FIRSTLY, cough­ing dur­ing sleep: by def­i­ni­tion, sleep is a state where there is di­min­ished aware­ness of, and re­spon­sive­ness to, ex­ter­nal and in­ter­nal stim­uli. Cough­ing is a re­sponse to an ir­ri­tant in­ter­nally. If that ir­ri­tant is of suf­fi­cient mag­ni­tude a per­son will still cough de­spite be­ing asleep — usu­ally caus­ing the per­son to wake up. Se­condly, pre­vent­ing colds through med­i­ca­tion or vac­ci­na­tion re­mains a huge chal­lenge for a num­ber of rea­sons. De­spite it be­ing called the com­mon cold, the in­fec­tion can be caused by a range of viruses. And each virus can have a variety of strains which are con­stantly chang­ing, mak­ing any vac­cine in­ef­fec­tive very quickly. We do have a flu vac­cine, but even that is de­vel­oped an­nu­ally with a new for­mu­la­tion, for the same rea­son. Each year the vac­cine pro­vides pro­tec­tion against the three most com­mon strains of the flu virus that were cir­cu­lat­ing among peo­ple in the north­ern hemi­sphere dur­ing their most re­cent win­ter. Un­for­tu­nately, the flu vac­cine will not pre­vent colds, or the flu caused by strains other than those three in the vac­cine. Pre­ven­tion against colds still re­lies on tech­niques such as avoid­ing con­tact with peo­ple with a cold, and fre­quent hand wash­ing. Re­cently, a re­view of the ev­i­dence found that echi­nacea did help in the pre­ven­tion and treat­ment of colds. For flu, there are two pre­scrip­tion drugs avail­able: Re­lenza and Tam­i­flu. They are very ex­pen­sive, but have been shown to re­duce the du­ra­tion of symp­toms and can help pre­vent the spread of the virus. I am­six weeks’ preg­nant and am plan­ning a trip to New Zealand in about six weeks’ time. From Melbourne it takes just un­der four hours. Is it safe to fly while preg­nant? AS­SUM­ING you don’t have any com­pli­cat­ing fac­tors, such as twins or gen­eral health prob­lems like di­a­betes or clot­ting disor­ders, you should be fine to fly, as the safest time to travel is in the sec­ond trimester of preg­nancy (from 12 to about 28 weeks). On jour­neys of more than four hours, par­tic­u­larly by plane, there is a slightly in­creased risk of de­vel­op­ing a deep ve­nous throm­bo­sis, or clot. Given the short du­ra­tion of the flight it is un­likely you will have a prob­lem, but it would still be best to stretch your legs fre­quently, drink plenty of flu­ids and, if your doc­tor thinks it worth­while, con­sider wear­ing com­pres­sion stock­ings. Linda Cal­abresi is a GP and ed­i­tor of Med­i­calOb­server. Send your queries to linda.cal­abresi@medobs.com.au

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