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Ulcer on the uvula (Canker sores)
Sep 14, 2000

Dear doctor

I have for the past month has one ulcer after another.Some on the inside of my cheek,others under my tongue.All of them have healed by 14 days.I have now got a small one on my uvula and this has caused my throat to hurt.I have had hiv test at 1,2,3,4,5,7 months after last exposure which was self masturbating in a public toilet.All were negative.

I also have geographic tongue.You say that if you get aphthous ulcers and they go away before 14 days by themselves then you are not immunosuppressed.With all my negative results how come I get these ulcers one after another? Could I be lacking something? Am I definitely negative? Is it normal to get an ulcer on the uvula?

Please can you answer me doctor

Response from Mr. Kull

It is not clear what causes apthous ulcers (canker sores). Apthous ulcers are small, painful, and shallow sores that can appear white or gray surrounded by a red halo. They usually appear on moveable, soft tissue inside the mouth -- the tongue, throat (including tonsils and uvula), and inner cheeks. Anywhere from two to fifteen ulcers can appear at one time and can individually last up to two weeks. Some people experience new canker sores in succession for up to one month. Several episodes a year are not uncommon. Canker sores can be very painful and may interfere with eating, drinking, and speaking.

No one is sure what causes canker sores; there may be many different causes for them. Stress and anxiety, mouth trauma, food allergies, gastrointestinal problems, immune suppression, and viral or bacterial infections have all been suggested as causes. Many people start getting them when they are coming down with a cold or the flu. It is not clear if they can be transmitted to another person (it seems unlikely, unless they are viral in nature).

There is no cure for canker sores but there are some suggestions to reduce the pain and possibly the sores' duration. Try rinsing and gargling with a salt and warm water solution three or more times a day. 2% hydrogen peroxide applied with a cotton applicator might also help. Some topical anesthetics help relieve pain (over the counter or prescribed by a doctor). Avoid acidic foods, chocolate, citrus, chips, or anything that makes them feel worse. Try to get some rest, especially if you are particularly stressed or anxious.

Let me change gears. At the risk of sounding harsh, you are getting tested way too much. The ulcers are not being caused by HIV if your only risk is masturbation. They are more likely to be caused by stress than HIV. I would suggest that you try to find a way to deal with your anxiety besides repeatedly getting HIV tested. It hasn't seemed to make you feel better yet.

RMK



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