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Bad Breath (HALITOSIS)

Halitosis, in its common term, means bad odor from the mouth or simply bad breath. It can be due to
various factors

Halitosis/bad breath can have oral (mouth) or non-oral (systemic) causes. Food substances that are
volatile like onion, garlic, spices and tobacco chewing and smoking can also cause bad breath

The major reasons for halitosis

1. Chronic sinusitis

2. Tonsillitis and tonsilolith (stone in tonsillar
crypts)

3. obstructive sleep apnea / snoring

4. Gastrointestinal problems( LPRD)

5. Pharyngeal pouches

6. Poor dental hygiene/ food impaction

7. Dental caries

8. Periodontitis( gum infections)

9. Coated tongue

10. Dry mouth( Xerostomia)

11. Cancers of upper aerodigestive area

12. Liver disorders, uncontrolled Diabetes

13. Drugs – like disulfuram, amphetamines

Chronic sinusitis will cause post-nasal drip and
biofilm growth in the nose and throat, which will result in bad breath. Similar to chronic tonsillitis,
chronic tonsillitis causes biofilms, stagnation of saliva, and foul breath. When you have gastrointestinal
discomfort, the back of your throat becomes inflamed, which causes bad breath.

How to test for halitosis

You need to visit an ENT doctor to rule out tonsillitis and sinusitis , which are the most common causes
of bad breath. A doctor may suggest an endoscopic examination for detailed assessment in case of
Reflux disorders (LPRD)

Treatment of bad breath

Correcting the cause for bad breath resolves the issue most of the time.
In addition to medical management of gastric disorders (LPRD), surgical clearance of sinusitis and
removal of infected tonsils can lessen bad breath.

1. Treatment for LPRD

2. Clearance of sinusitis

2. Clearance of sinusitis

4. Maintain proper oral hygiene

5. Use mouth rinsers

6. Tooth brushing and interdental flossing

7. Periodic Dental check up

8. Maintain good water balance.

Additionally, bad breath might be a covert indicator of cancer and pharyngeal pouches. If you have
persistent bad breath, make an early appointment with the doctor

– Dr. Prashanth R Reddy
“E.N.T. health – ENTry for better senses”.

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Tonsillitis – FAQs

Tonsils are a pair of lymphoid tissue at the back of the throat. They play a major role in immunity by fighting against bacteria and viruses that enter the body via the mouth and nose.

What is Tonsillitis?

Tonsillitis means inflammation of the tonsils. It can be due to Viral infection ( most common) or can be due to bacterial infection. It mainly presents as acute tonsillitis, within 7 days of infection.

What are the signs and symptoms?

● Sore throat

● Fever

● Difficulty in swallowing/ drinking

● Swollen and red tonsils

● Ear ache

● General fatigue

● Swelling of lymph nodes on the side of the neck

● Bad breath

When to do surgery for tonsillitis?

● Recurrent tonsillitis, more than 7 times a year

● Tonsillitis progressing to abscess

● Tonsillitis causing high-grade fever/ seizure

● Bad Breath/ bad taste not responding to medical treatment

What happens if tonsillitis goes untreated?

It can lead to many serious medical conditions like abscess formation/ Sepsis and may need Intravenous antibiotics and prolonged hospital stay

What precautions can be taken at home to promote recovery?

Your doctor may prescribe antibiotics. In these cases, the below-mentioned home remedies can also help both adults and children.

● Consume adequate fluids. Give your child plenty of water to keep his or her throat moist and prevent dehydration.

● Take comforting foods and beverages. Warm liquids — broth, caffeine-free tea or warm water with honey — and cold treats like ice pops can soothe a sore throat.

● Prepare a saltwater gargle. A saltwater gargle of 2 teaspoons of table salt to half a glass (100 milliliters) of warm water can help soothe a sore throat and reduce the swelling of the tonsils/throat. Gargle the solution and then spit it out.

● Prepare a saltwater gargle. A saltwater gargle of 2 teaspoons of table salt to half a glass (100 milliliters) of warm water can help soothe a sore throat and reduce the swelling of the tonsils/throat. Gargle the solution and then spit it out.

● Always humidify the air. Use a cool-air humidifier to eliminate dry air that may further irritate a sore throat, or sit with your child for several minutes in a steamy bathroom.

● Offer lozenges to children to relieve a sore throat.

● It Is also necessary to avoid irritants. Ensure your home is free from cigarette smoke (any form of passive smoke) and cleaning products that can irritate the throat.

● You can talk to your doctor about using ibuprofen in order to minimize throat pain and control fever. Remember low fevers without pain do not require treatment.

● If aspirin is not prescribed by your doctor to treat a particular disease, it is recommended that children and teenagers should stay away from taking aspirin. Aspirin use by children can lead to Reye’s syndrome, a rare but potentially life-threatening condition.

Adjust your lifestyle habits and remember to follow your doctor’s instructions to lead a healthy life.

Dr. Prashanth R Reddy
“E.N.T health – ENTry for better senses”

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All About Heartburn and Foods that Prevent Acid Reflux – FAQs

A quick guide for heartburn, acid reflux and the diet that can be followed under the advice of your ENT doctor or dietician

What is heartburn?

Heartburn is a burning feeling in the chest caused by stomach acid traveling up towards the throat (acid reflux).

If you experience heartburn repeatedly, it is called gastro-oesophageal reflux disease (GORD).

Let us first see if you have acid reflux:

The main symptoms are:

▪ Mostly heartburn – a burning sensation in the middle of your chest

▪ an unpleasant sour taste in your mouth, caused by stomach acid

▪ bad breath

▪ a hoarse voice

▪ bloating and sick feeling

▪ a cough or hiccups that keep coming back

Note: Few symptoms are often worse after eating, when lying down or even when bending over.

Causes of heartburn and acid reflux

Many people get heartburn from time to time. There is often no obvious reason why.

Acid reflux is caused or made worse by:

▪ certain food and drink – such as coffee, tomatoes, chocolate and fatty or spicy foods

▪ being overweight or being obese

▪ smoking and alcohol

▪ pregnancy

▪ stress and anxiety

▪ some medicines, such as anti-inflammatory painkillers (like ibuprofen)

▪ a hiatus hernia – when part of your stomach moves up into your chest

▪ a diet that is high in acidic foods

▪ eating large meals or lying down immediately after eating

What foods can cause acid reflux?

It is also important to check out the foods that can be harmful to your health during this condition. Here are some foods that you can avoid:

Fried foods:

Fried foods are one of the worst offenders when it comes to acid reflux. This is because they are high in fat, which can delay stomach emptying and lead to increased production of stomach acid. Moreover, fried foods are often loaded with salt, which can further aggravate your symptoms.

alcohol consumption

When you’re going out for a night with friends or a date night, you might want to splurge by pairing a beer or a glass of wine (or two) with dinner. Well, think twice before you pop open that second bottle, because alcohol has been shown to slow the rate at which your food snakes through your digestive system. This means your food is not being broken down as rapidly as it should, and it sits in your stomach, which increases your likelihood of enduring an acid reflux episode

Spicy foods

This one is a bit of a no-brainer. When you suffer from reflux, your esophagus already feels like it’s on fire, and the last thing you want is to eat something that ignites the flames any further. Rizzo says that spicy foods can trigger acid reflux symptoms in many people for primarily two reasons.

Carbonated beverages

Carbonated beverages, such as soda and seltzer water, can also trigger your symptoms. This is because they are high in carbon dioxide, which can cause bloating and belching. Additionally, carbonated beverages can also irritate the lining of the esophagus, further aggravating your symptoms.

Citrus fruits

Citrus fruits, such as oranges, lemons, and grapefruits, are extremely acidic. This means that they can trigger your symptoms and make them worse. If you enjoy citrus fruits, be sure to eat them in moderation.

Your morning cup of coffee

That morning cup of coffee may just be sending your esophagus into a burning tizzy. If you notice that you experience reflux after your cup of coffee, you may be better off switching to green tea.”

Sour Foods

Sour foods can trigger your symptoms. Furthermore, tomatoes are often used in sauces and other dishes, which can make them even more problematic for those with acid reflux.Garlic is a common ingredient in many dishes. However, it can be problematic for those with acid reflux. This is because garlic is high in sulfur, which can increase stomach acid production and lead to heartburn.

What foods can I have if I have an urge to eat sweets?

What sweets you can eat with acid reflux is an important question because you need to be careful about your diet during this condition. You can enjoy the foods given here without triggering your symptoms. However, be sure to talk to your doctor or dietitian about what sweets are best for you.

Dark chocolate

Chocolate lovers rejoice! Dark chocolate is actually good for those with acid reflux. This is because dark chocolate has lower fat content than milk chocolate or white chocolate. Additionally, dark chocolate contains flavonoids, which have antioxidant properties.

Fruit

Fresh fruit, such as apples, bananas, and grapes, are great choices for those with acid reflux. These fruits are relatively low in acidic content and have natural sweetness, making them less likely to trigger your symptoms.

Low-fat Custard

You can also have pudding or custard made with low-fat milk as a sweet treat. But don’t overindulge and only eat a small portion as overeating might upset your stomach.

Oatmeal with Honey

Oatmeal is another great option for those with acid reflux and you can add honey to add sweetness. This whole grain contains soluble fiber, which can help to absorb stomach acid and minimize symptoms. And oatmeal is a good source of protein, which can help to keep you feeling full and prevent overeating.

Frozen Yogurt

Yogurt is a good choice for those with acid reflux, as it contains probiotics. These beneficial bacteria can help to promote gut health and reduce the symptoms of acid reflux. You can have sweetened or flavored yogurt as a snack.

Ginger Tea

Ginger is a well-known natural remedy for nausea and upset stomach and makes a great tea that can be sweetened with honey. Additionally, ginger can help to reduce inflammation in the digestive tract. This makes it an ideal choice for those with acid reflux

When to seek medical help?

– lifestyle changes and pharmacy medicines are not helping your heartburn

– you have heartburn most days for 3 weeks or more

– you also have other symptoms, like food getting stuck in your throat, frequently being sick, or losing weight for no reason

Your ENT doctor can provide better treatments and help rule out any more serious causes of your symptoms after examining you.

– Dr. Prashanth R Reddy
“E.N.T. health – ENTry for better senses”.

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Burning mouth syndrome – FAQ

So, what is burning mouth syndrome?

Burning mouth syndrome, also known as glossodynia, refers to pain or a hot, burning sensation in the mouth or oral cavity. Most patients experience it on the tongue, but some patients may feel burning in multiple areas of the mouth, including the lips, top, or bottom of the mouth.

It is an ongoing or recurrent burning in the mouth without an obvious cause. This discomfort may affect the tongue, gums, and lips, inside of your cheeks, roof of your mouth (the palate); or widespread areas of your whole mouth.

The burning sensation can sometimes be very severe, and it usually appears suddenly. The burning mouth syndrome may last for months to years. This doesn’t cause any noticeable physical changes to your tongue or mouth.

The deficiency of vitamin B12 finally resulted in high blood homocysteine levels in these patients. Burning sensation, dry mouth, and numbness of the tongue were the three most common symptoms of patients with Burning mouth syndrome.

Note: Burning mouth syndrome can start as soon as you wake up and last the whole day, or the burning sensation could come and go. This may also occur every day, with little discomfort when you wake but becoming worse as the day progresses.

Here are the symptoms of burning mouth syndrome:

▪ Loss of taste

▪ Tingling, stinging or numbness in your mouth

▪ Burning sensation that most commonly affects your tongue may also affect your lips, gums, palate, throat or whole mouth

▪ Taste changes in your mouth. E.g. Bitter or metallic taste

▪ Dry mouth with increased thirst

Important note: The risk may be greater if:

▪ You’re a woman

▪ You’re premenopausal or postmenopausal

▪ You’re over the age of 50

Factors that may increase your risk of developing burning mouth syndrome include:

▪ Any recent history of fever

▪ Any previous dental procedures

▪ Allergic reactions to food

▪ Medications especially pain killers

▪ Stress

▪ Depression

▪ Traumatic life events

▪ Some chronic medical disorders such as fibromyalgia, Parkinson’s disease, autoimmune disorders and neuropathy

Health tip:

Avoid acidic foods, spicy foods, carbonated beverages, tobacco, and excessive stress, and you may be able to reduce the discomfort from burning mouth syndrome. or by sucking ice chips

Remember, there is no over-the-counter medication available for burning mouth syndrome.

Visit your ENT doctor if you have discomfort, burning, or soreness in your tongue, lips, gums, or other areas of your mouth. Your ENT doctor will be able to help develop an effective treatment plan.

– Dr. Prashanth R Reddy
“E.N.T. health – ENTry for better senses”.

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Voice change

So, what is “voice change” or “hoarseness”?

Voice change, also known as hoarseness, originates from some issue or disorder with the vocal cords (part of the larynx or the voice box responsible for producing sounds). Voice change can be caused by many factors, but it may not be as serious if it heals within a few days. But if the voice change condition continues for more than a week, you should visit an ENT physician at the earliest opportunity to rule out larynx cancer.

Remember in most cases, hoarseness can be relieved by resting the voice.

To begin with, your doctor will first take a detailed history of your voice change problem and overall health, also do a physical checkup of the voice box and its surrounding area, a laryngoscope, which is a compact and flexible instrument with an in-built light that can be placed at the back of the throat. Post this, your doctor will then assess the quality of your voice. After that, depending on the findings of the physical investigation, your ENT physician may prescribe simple precautions or suggest lab tests (e.g. biopsy), x-rays, or thyroid function testing, etc.,

Note: Acute laryngitis is the most common cause of hoarseness and voice loss that starts suddenly. Most cases of acute laryngitis are caused by viral infections that lead to swelling of the vocal cords. When the vocal cords swell, they vibrate differently, leading to hoarseness. Dysphonia refers to having an abnormal voice. It is also known as hoarseness or voice change.

Important note:

Smokers are at a very high risk of developing edema of the vocal cord (Rinkiess edema), which contributes to voice change.:

Smokers will be counseled to give up smoking and get enough voice rest.
Also, second-hand smoke, or passive smoking, is harmful.
The doctor may ask you to avoid spicy food too.

Note: Acute laryngitis is the most common cause of hoarseness and voice loss that starts suddenly. Most cases of acute laryngitis are caused by viral infections that lead to swelling of the vocal cords. When the vocal cords swell, they vibrate differently, leading to hoarseness. Dysphonia refers to having an abnormal voice. It is also known as hoarseness or voice change.

Few lifestyles and home remedies

✔ Breathe moist air. Use a humidifier to keep the air in your home or office moist.

✔ Rest your voice as much as possible. Avoid speaking in a loud voice as well as whispering.

✔ Drink plenty of fluids to prevent dehydration (avoid alcohol and caffeine).

✔ Moisten your throat.

✔ Avoid decongestants.

✔ Avoid whispering.

Adjust your lifestyle habits and remember to follow your doctor’s instructions to lead a healthy life

– Dr. Prashanth R Reddy
“E.N.T. health – ENTry for better senses”.


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Suffering from Acid reflux / Nasal Allergy?

Tips and home remedies to avoid acid reflux burnout and nasal allergy with ease.

To live a healthy life requires taking care of your well-being and adopting a healthy lifestyle and healthy habits:

1. Avoid spicy food since it worsens acid reflux and also causes stomach ulcers and gastritis.

2. Reduce your intake of oily/fried/junk foods, and excessive amounts of coffee, tea, and alcohol (no more than two cups per day), which can harm your organs, cause you to gain weight, and raise your risk of acid reflux and snoring (especially alcohol intake)

3. Avoid chocolates, soft drinks, and soda, as well as sour foods, since they are high in calories, salt, and saturated fats. This increases the chances of acid reflux.

4. Regular meals at regular intervals improve metabolism, provide a more steady energy supply, and lower the risk of becoming acidic and gaining weight as a result of binge eating.

5. Food must be taken at least 2 hours before bedtime, as it takes a minimum of 2 hours for the stomach to empty out, or you are likely to develop acid reflux and end up choking or coughing during sleep.

6. Water should be consumed 30 minutes before bed since it takes at least 30 minutes for it to reach the intestines; this keeps you hydrated throughout the night and helps your body get rid of harmful toxins

7. Salt water gargling, which is to be done with 2 tsp of salt in 100 ml of water (a very high concentration of salt), helps to reduce throat swelling, which in turn lessens throat irritation, soreness, dry coughing, and nose block.

8. Steam is the most effective mucolytic, it is imperative to inhale steam using pure water (without adding anything to it), boiling water on a stove, or using an electric vaporizer (mucous solvent). This aids in clearing up the ENT region’s congestion.

9. Your bed should be inclined. Avoid sleeping on a flat mattress. Sleep in an inclined/sloped position by raising the head end of the bed up to 6 inches (15 cm. to 20 cm.) by putting newspaper bundles or a pillow under the head end of your mattress. This encourages you to avoid breathing through your mouth as you sleep in order to optimize your nasal breathing while also preventing congestion.

10. Do not wear tight-fitting clothes, especially around the chest and waist, which put more pressure on the stomach, which can lead to acid reflux and make it harder to breathe. Your body temperature can rise when you dress tightly, which is not ideal for good-quality sleep.

11. Lose weight if you’re overweight or obese, as it will help reduce acid reflux and snoring too.

12. Avoid direct cold air from AC vents, which can cause sinus/asthma-related problems. Regularly clean the AC vents, as bad air quality (if the vents aren’t cleaned well) will aggravate nasal allergies.

13. Avoid triggers of allergies like dust, smoke, pollution, pollen, perfumes, deodorant sprays, and aerosols. Avoiding contact with pets helps control nasal allergies as animal dander is one of the common allergens

14. While riding a bike, wear a helmet that covers your face partly or wholly, as it protects your head from an accident and also prevents pollution and dust from coming in contact with your face and ENT.

15. Both warm and cold compresses can relieve pain from any part of the body (As recommended by your doctor)

16. Regular cleaning of Bedsheets in Hot water and drying in sunlight helps reduce nasal allergies from cotton threads

17. Stop smoking -as it increases the chances of suffering from cancer and triggers all sorts of allergies with gastritis

18. Reduce stress, because stress is a known factor to induce acidity/ acid reflux

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