HomeAnswersOtolaryngology (E.N.T)laryngopharyngeal refluxWhat does symptoms like excessive gas, belching, bad taste and hairy tongue indicate?

I experience stomach cramps, excessive gas, belching and bad taste. Please help.

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Vinodhini J.

Published At March 1, 2020
Reviewed AtDecember 14, 2023

Patient's Query

Hello doctor,

I am a 42-year-old male. My height is 5' 11" and I weigh about 264.55 lb. I do not do any exercise. Just a month ago, I experienced painful stomach cramps, diarrhea, excessive gas, sweating, and belching with bad taste which lasted for one night. I rested up for two days and felt much better but a cold sore appeared on my lip which again only last a few days. I am not sure if it is related but quite shortly the aforementioned incident I noticed enlarged papillae slightly apart from the others. I was naturally curious so rubbed it with my finger and it did not feel any pain so I just forgot about that. Shortly after I started to feel pain in my tongue, the pain would change location throughout the day and often move to my hard palate. I then noticed my tongue appeared white coated. I started to use oral thrush lozenges, rinse my mouth with mouthwash, gargle with warm water and salt, brush my teeth and tongue before bed (I never used to). After a few weeks, my tongue appeared pinker but the pain is still on and off. I finished the lozenges hoping that would be the end of it but I have noticed today that my tongue again appears white-coated and I now feel sore on the hard plate near the front teeth, also a new cold sore has appeared. I have read and looked at the photos about oral thrush, hairy tongue and so on but really I have no idea what my condition is. I have not been to see a doctor or dentist because quite honestly I am very scared. Reading that white-coated tongue causes can be anything from excessive alcohol, tobacco use right through to HIV or cancer is simply terrifying me. I did purchase a diabetes home test kit (urine) which did not show any traces. I drink and vape once a week but on that day I consume both excessively. Please shed some light and guidance. Photos run in chronological order.

Answered by Dr. Vinay. S. Bhat

Hi,

Welcome to icliniq.com.

First of all, thank you for the detailed history of your symptoms and photos which you have attached. (attachment removed to protect patient identity). Before I discuss further about possible diagnosis let me assure you that your symptoms or the photos you have sent do not show anything sinister in your mouth or tongue. Analysis of your symptoms are suggestive of a condition known as laryngopharyngeal reflux disorder (LPRD) where backflow of digestive acid causes significant injury to throat and mouth structures including tongue and palate. In your case symptoms seems to be triggered by an initial attack of acute gastritis and reflux, which may have caused significant injury. Acid can injure tongue papillae causing a coating of tongue, multiple small ulcerations, inflammation of tongue papillae. If the reflux continues to occur it can keep injuring different areas of tongue and mouth leading to migration of symptoms. Occasional binge drinking and vaping seems to be causing further damage to already injured tissue. You may need to take a few week course of anti-reflux medications and avoid drinking and vaping while on treatment to facilitate the healing process. Other than this I do not see anything dangerous as per the photos you have attached. Also, it does not look like oral thrush (oral candidiasis). So antifungal lozenges may not be of much use.

Patient's Query

Hello doctor,

Thank you for the suggestion of taking a course of anti-reflux medications. I followed your advice and my tongue pain reduced. However, on closer inspection of my tongue, I noticed something on the backside of my tongue. I have attached photos for your evaluation. Due to the Covid-19 crisis, I am reluctant to travel to my local dentist or doctors. I hope you may be able to offer me some advice.

Answered by Dr. Vinay. S. Bhat

Hello,

Welcome back to icliniq.com.

I have seen the pictures (attachment removed to protect the patient's identity). What you are seeing on the back of the tongue is known as foliate papilla. It is a normal taste bud and many times very prominent and looks like a swelling. Unless there is pain associated, there is no need for any treatment.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Vinay. S. Bhat
Dr. Vinay. S. Bhat

Otolaryngology (E.N.T)

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