Why can’t I get rid of this metallic taste in my mouth?

ASK DR ELLIE CANNON: Why can’t I get rid of this metallic taste in my mouth?

Q. I’ve been diagnosed with oral lichen planus, which means I have a terrible metallic taste in my mouth that overpowers just about anything I eat. It’s miserable. Do you have any advice?

A. This is a common condition thought to affect two per cent of the population with symptoms resulting from inflammation within the mouth.

We don’t know for sure what causes it, although it is believed to result from problems with the immune system.

It is not an infection and it is not usually hereditary.

Oral lichen planus (pictured) can cause red patches, ulcers or blisters and be very painful. Typically this causes burning and stinging, particularly when eating and drinking

There are visible changes inside the mouth. It can be seen on the inside of the cheeks, gums and the sides of the tongue as lacey white patches often in a symmetrical pattern on both sides.

If there are red patches, ulcers or blisters, then the condition can be painful. Typically this causes burning and stinging, particularly when eating and drinking.

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Lichen planus can have triggers and it is worth keeping a diary to highlight if it is worsened with certain foods or drink, stress or action in the mouth, for example vigorous brushing or tongue-scraping or dental work.

Some lichen planus may be related to certain metal fillings, which can be replaced.

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Topical treatments within the mouth are can be used to ease symptoms – typically steroid sprays, mouthwashes or pastes.

We often recommend patients use a gargle for two to four minutes, three or four times a day. An example would be 400mcg flixonase or 500mcg betamethasone dissolved in 10ml of water as a gargle. Your GP can prescribe these.

Rigorous oral hygiene is imperative, and because of the small increased risk of mouth cancer associated with oral lichen planus, regular oral or dental check-ups are crucial.

It’s a distressing condition and there is a sufferers’ support group: UK Lichen Planus (uklp.org.uk).

Q. I suffer from colitis and, distressingly, I’ve found I’m becoming unable to control my bowel. I am currently waiting to hear from the specialist, but can you give any advice on my diet to help this condition?

A. Colitis is an inflammatory bowel condition with changes in the colon and rectum that cause chronic diarrhoea. It is worth exploring the triggers for urgency, using a food diary over two weeks. Commonly, alcohol, caffeine and dairy products are factors.

DO YOU HAVE A QUESTION FOR DR ELLIE? 

Email [email protected] or write to Health, The Mail on Sunday, 2 Derry Street, London, W8 5TT. 

Dr Ellie can only answer in a general context and cannot respond to individual cases, or give personal replies. 

If you have a health concern, always consult your own GP.  

Sugar, particularly artificial sugars and sweeteners, draws water in the gut and may make it harder to hold on. Specialists may recommend a low-fat and low-fibre diet avoiding nuts, legumes and raw vegetables.

Specific foods to reduce diarrhoea include rice, bananas and cooked apple.

Over-the-counter drugs such as loperamide may be used in colitis: this will reduce the number of toilet visits a day.

Crohn’s & Colitis UK (crohns andcolitis.org.uk) is a fantastic resource if you are searching for more information.

Nigella’s right back on drinking

A stiff drink might seem like a good way to unwind. But, paradoxically, the way alcohol acts on the brain and body means that it exacerbates low mood and anxiety.

Last week, TV chef Nigella Lawson, left, admitted she’d cut back her drinking because although it calmed her nerves at first, it later left her with ‘a horrible tight feeling of worry’.

TV chef Nigella Lawson (pictured) has said she will be cutting back her drinking as it left her with ‘a horrible tight feeling of worry’

I often hear the same story from patients who find that as soon as they reduce their intake of alcohol and coffee, the mysterious panic that plagues them starts to subside.

Would you pay £10 to see a GP quickly? This question was posed to thousands of NHS patients as part of a national survey last week. The idea isn’t much different to choosing to pay for priority boarding on a budget airline.

My worry is that those who can afford to pay for medical attention may not be the ones who need it the most, and the elderly and vulnerable will inevitably end up at the back of the queue.

This push towards greater patient choice is all very well, providing the schemes benefit everyone equally. Would I pay to bump the queue ahead of a fellow patient? Absolutely not.

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