Oral Ulcers: Causes, Treatment, and Risks of Transmission - Internal Medicine

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Oral ulcers, commonly known as canker sores or aphthous ulcers, can be a frustrating and painful condition for many individuals. Understanding their causes, treatment options, and the risks associated with transmission is crucial for managing this condition effectively.


Causes of Oral Ulcers
Oral ulcers can arise from a variety of factors. The exact cause is often unknown, but several potential triggers include:
1. Stress and Hormonal Changes: Emotional stress and hormonal fluctuations can lead to the development of ulcers. This is particularly relevant for individuals who experience recurrent ulcers.

2. Nutritional Deficiencies: Deficiencies in vitamins and minerals, particularly vitamin B12, folate, iron, and zinc, can contribute to the formation of oral ulcers.

3. Food Sensitivities: Certain foods, such as citrus fruits, chocolate, and spicy foods, may trigger or exacerbate ulcers in some individuals.

4. Underlying Health Conditions: Conditions such as Behçet's disease, inflammatory bowel disease (IBD), and celiac disease can lead to recurrent oral ulcers.
5. Medications: Some medications, including non-steroidal anti-inflammatory drugs (NSAIDs) and certain chemotherapy agents, can cause oral ulcers as a side effect.

In your case, the fact that you have been experiencing recurrent oral ulcers for 2-3 years despite normal blood tests suggests that there may be an underlying issue that has not yet been identified. The improvement you noted with colchicine (秋水仙素) indicates that inflammation may play a role in your symptoms. However, the recurrence upon reducing the dosage suggests that a long-term management strategy may be necessary.


Treatment Options
Managing oral ulcers often involves a combination of symptomatic relief and addressing underlying causes:
1. Topical Treatments: Over-the-counter topical anesthetics, such as benzocaine, can help numb the pain. Additionally, corticosteroid ointments may reduce inflammation and promote healing.

2. Oral Rinses: Antimicrobial mouthwashes or saltwater rinses can help keep the area clean and reduce irritation.

3. Dietary Adjustments: Identifying and avoiding trigger foods can help minimize the frequency of outbreaks. Ensuring a balanced diet rich in vitamins and minerals is also essential.

4. Medications: For recurrent or severe cases, a healthcare provider may prescribe systemic medications, such as corticosteroids or immunosuppressants, to manage inflammation.

5. Stress Management: Techniques such as mindfulness, yoga, or counseling can help reduce stress levels, potentially decreasing the frequency of ulcers.


Risks of Transmission
Regarding your concern about kissing while having oral ulcers, it’s important to note that the risk of transmitting infections through kissing is generally low if the ulcers are not caused by a contagious condition. However, certain viral infections, such as herpes simplex virus (HSV), can be transmitted through oral contact. If your ulcers are due to a viral infection, there is a risk of transmission during kissing.

If you are experiencing recurrent oral ulcers and are concerned about the potential for sexually transmitted infections (STIs), it may be beneficial to consult with a healthcare provider. They can perform appropriate tests to rule out any underlying infections and provide guidance on safe practices.


Conclusion
In summary, oral ulcers can be caused by a variety of factors, including stress, nutritional deficiencies, and underlying health conditions. Treatment often involves a combination of symptomatic relief and addressing any underlying issues. While kissing with oral ulcers generally poses a low risk of transmission, caution is advised, especially if there is a possibility of a viral infection. Consulting with a healthcare provider can help you develop a comprehensive management plan tailored to your specific needs.