How can I overcome bad breath?

Doctor,

I am having a bad time relating with my friends because my mouth produces very bad air. What causes this and how can I be helped?

Amos

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Dear Amos,

The most common cause of bad breath or halitosis is infections of the oral cavity. Due to poor oral hygiene, food particles remain stuck in between teeth and around gums . These attract bacteria and form a nidus for bacteria to grow. Thus chronic infection of the teeth and gums sets in giving a bad breath to the individual.

People with reduced immunity can suffer from fungal infections of the mouth, causing difficulty in swallowing as well as bad breath. Drinking adequate quantity of water and rinsing the mouth, after eating, helps to cleanse the mouth. Failing to do so can add on the bad breath.

Food eaten is initially processed in the mouth. It is broken down into small particles and moistened by saliva. The salivary enzymes initiate process of digestion. Foods with bad odour like garlic, onion can also cause bad breath, particularly if consumed raw.

Among disease conditions, diabetes commonly causes a bad breath. In fact, halitosis may be the first sign of diabetes. Halitosis can also be caused by liver and kidney disorders. It can be due to acid reflux from the stomach.

Too much of sugary food, use of alcohol or excess caffeine and smoking are some other factors which lead to bad breath.

Prevention of bad breath lies in maintaining good oral hygiene. Clean teeth thoroughly at least twice a day, once in morning and then in night before sleeping. Ideally if possible, it can be done after each meal, otherwise rinse mouth adequately after meals, with clean water.

If halitosis is already present, the mouth can be rinsed with antiseptic mouth wash. The tooth brush used should be with soft bristles and change immediately the bristles start getting worn out. It is recommended by dentists to use dental floss at least 2,3 times per week. The tongue should be cleaned with a tongue cleaner.

Avoid sugary food, alcohol, smoking and excess of caffeine. Treatment of bad breath consists of treatment of underlying cause.

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Can water alone heal flu?

Doctor,

Can flu get cured by one simply taking big quantities of water?

Nasra

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Dear Nasra,

Flu is a viral infection, which is manifested by a running nose, blocked nose or sneezing. It may be associated with sore throat, muscular and joint pains, with or without fever. People use this term loosely to describe any common cold, which may be due to allergy as well. Viral infections are usually self subsidising. Even without any specific treatment, it clears in a week or maximum 10 days.

Drinking adequate quantity of water helps in reducing severity of the symptoms of flu and can shorten its duration. Studies have shown that those who drank more water recovered more quickly from flu. Flu with or without fever, tends to dehydrate the body.

Drinking much water, keeps the body well hydrated. This helps in reducing stuffiness of the nose and sore throat. It also keeps the inner lining of nose moist, which is the first line of defense of the respiratory system. It wards off dust and germs from entering the body.

Most importantly, water helps to remove toxins from the body. Hence adequate amount of water helps in curing a flu faster. Plain unflavored water is always a better choice than juices as they have high sugar content. Alcohol and caffeinated products should be avoided as they tend to cause dehydration.

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Taking water makes me want to vomit

Doctor,

I have heard and read that taking a glass of water in the morning is a healthy practice. However, whenever I take water in the morning I feel like throwing up. What causes this feeling and how can I overcome it?

Emmanuel

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Dear Emmanuel,

A glass of water in the morning first thing is definitely a healthy practice. It helps in cleansing bowels, removing toxins from the body by producing more urine, gives a feeling of freshness.

However if one has excess of acid in the stomach as due to acid peptic disease or peptic ulcer, there may be a tendency to throw out water. It can also occur due to alcohol consumed in the night. Taking excess coffee in the night before sleeping can also cause nausea in the morning and one can put out water consumed first thing in morning. Similar thing can happen if one has taken dinner very late in the evening or taken a very heavy dinner. This happens because food is not digested properly and creates dyspepsia. Constipation, where the bowels are not emptied in morning, could also make one throw out water. Allergy to some food substance, consumed in the night can also manifest as nausea in the morning.

Try eating early in the evening, at least 2 hours before sleeping, avoid heavy meals in night, avoid alcohol and coffee in night. Taking a fiber rich food and sufficient quantity of water in the day time, keeps digestion good and also helps prevent constipation. You can also try to take small quantity of water, first thing in the morning, then gradually increase the quantity after 3-4 days. This shall help you in tolerating it better.

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My skin itches whenever I take a bath

Doctor,

Whenever I take a shower my skin itches. I have applied different ointments in vain. Is there any drug that might be helpful?

Jessica

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Dear Jessica,

Is your problem recent or have you had it for some time. Does itching occur in a particular climate or round the year.

Itching can be due to excess dryness of the skin. Dryness leads to irritation if water or any substance like soap or lotion touches the skin. Using very hot water to shower can also leave the skin dry and parched and cause itching afterwards. Such extreme dryness can be due to exposure to dust, draughts of hot or cold air or even exposure to excess sun. Under functioning of the thyroid gland, diabetes, are some of the hormonal disorders that can as well lead to dryness. Nutritional deficiency particularly of vitamin B complex and some essential minerals can manifest as dry skin. Allergy to any body care product or even water can cause itching after a shower. One may have eczema of the skin where the existing itching is aggravated after contact with water. Similarly with fungal infections of the skin, itching may be aggravated after a shower.

It is a good idea to avoid very hot or cold water for a shower. Use mild soap. A suitable moisturizing agent should be applied to the skin when it is still damp after a shower to prevent dryness. If possible a humidifier can be used in the room where one is working to avoid the room air becoming too dry.

Any body care product suspected of causing allergy should be avoided. Having a balanced diet prevents nutritional deficiencies causing dryness and itching.

Whatever the reason, itching is uncomfortable and also embarrassing. It also increases risk of secondary bacterial infections due to scratching. This results in boils. Chronic inflammation of the skin can also occur due to scratching, which adds to the discomfort. If itching is severe, it is useful to take some anti allergy tablet like chlorphenaramine maleate or cetrizine. Use of a local anti allergy cream also helps to reduce itching.