Why Is The Roof Of My Mouth So Sore?

[bravejordy]

I'm male, 58, with, among other things, type 2 diabetes (diagnosed six years ago). I don't smoke or drink and my regular meds are as follows:-


METFORMIN 500MG - TWO to be taken TWICE a day

EPILIM 200MG - One tablet THREE times a day

RAMIPRIL 5MG - ONE capsule a day

RAMIPRIL 2.5MG - ONE capsule a day

LIPITOR (ATORVASTATIN) 10MG - ONE tablet DAILY



I also have a history of Urinary Tract Infections going back over three years. This year alone I have suffered from four UTIs for which my GP prescribed a course of antibiotics (either Trimethoprim or Amoxicillin) which only seem to offer relief while I'm actually taking them and when I've finished the course all the symptoms return with a vengeance. I am under a Urologist because three years ago it turned out to be kidney stones that was the cause of my problems. I am due to see the Urologist again at the end of this month.


However, getting back on track, I have yet another UTI and four days ago my GP prescribed a 7-Day course of Trimethoprim 200MG but the day after starting the course, the inside of my mouth (especially the roof) became very sore and swollen. It's too painful to eat anything and the only way I can drink a cup of tea is to let it practically go cold. The big question is could it be the Trimethoprim that's causing this? But like I said, I've had these antibiotics before and I don't recall having any side effects but it does seem strange that this sore mouth came on suddenly and within 24 hours of starting the course of Trimethoprim. I can't think of any other cause. It's driving me nuts!

[237SJ]

I`m not an expert but could it be oral thrush? People with diabetes can be prone to that. Maybe the Trimethoprim contributed as well. I was prescribed that by a doctor and it gave me the most terrible thrush (not in the mouth though!). She said that wasn`t a side effect of the drug but I beg to differ.

[bravejordy]

Thanks 237SJ, I'll certainly look into it. I'm due to finish the course of Trimethoprim on Wednesday so fingers crossed, the soreness in my mouth will go away as quickly as it came.

[ladyalex]

If it is thrush, then you will probably have to get some anti- fungal medication from your GP....best go back and get it checked out anyway.

[Hopkirk]

Probably a silly suggestion, but if I eat pizza that is too hot, the cheese burns the top of my mouth and it is painful for days afterwards - in the way you describe.

[bravejordy]

Thanks ladyalex, I do have an appointment to see my GP later this week so I'll see what he says.

Thanks Hopkirk, I definitely haven't eaten anything too hot because one of the symptoms of my UTIs is that I lose my appetite and since last week I'm lucky if I can manage a sandwich of cold cuts (which is basically all I've been eating when I've been eating). Right now though, anything I eat is proving painful, even yoghurt. Don't get me wrong, I have burned my mouth in the past, eating hot foods (those cheese pasties from Sayers are lethal!) but it has just been one area of my mouth and certainly never anything like this. This, on the other hand, seems to be affecting my whole mouth and gums (both top and bottom) but the roof of my mouth is where it seems more painful. I've even tried rinsing my mouth with Corsodyl, but I'm a bit worried about using a mouthwash with alcohol content while I'm on antibiotics.

[chi-chi66]

Bravejordy... do you ever read the folded info sheet inside of the medication.

You can get a degree of info from that...I have had bad experiences from meds...could write a book....When you go back to you're GP tell him, sometimes they pooh pooh it...but be firm.. Too much antibiotics and it causes problems, does'nt solve them. good luck.

[Sqad]

Clearly I am "flying blind" here as you haven't given me an accurate enough description of the lining of your mouth. It could be fungal, viral or indeed not an infection at all........my best guess is that it is a stomatitis secondary to taking Trimethoprim.

Drink plenty of water.....suck ice cubes and take Ibuprofen 400mgms for the pain if and when necessary up to every four hours.

[bravejordy]

chi-chi, yes I did read the leaflet that came with the Trimethoprim and the possible side effects but the only things listed that are remotely related to what I have are swollen tongue and mouth ulcers. To be fair, the Trimethoprim have eased the symptoms of my Urinary Tract Infection. This time last week I honestly thought I was at death's door with a fluctuating temperature, sweating profusely during the night and having to get up two or three times to change my bedding because it was soaked through. Then, when I wasn't sweating, it would go to the other extreme of feeling really cold and shivering with a fever-like chill. This went on from Monday to Thursday when, out of sheer desperation, I dragged myself from my sick bed and went to see my GP. To be honest, if I had to choose between how I was feeling last week and this sore mouth, I think it goes without saying that the sore mouth is the lesser of the two evils.

Thanks sqad, yes, I'm already drinking lots of water with having a UTI, but I took your advice and tried sucking ice cubes and it did seem to soothe the inflammation in my mouth. I'll see how things go today and if necessary, use your other advice of taking Ibuprofen to ease the pain.

Thanks again, everyone. :o)

[ladyalex]

I think you should stop being so brave, bravejordy....painkillers are there for us to use when we have pain. There are no prizes for suffering.
Also, why don't you give your GP surgery a ring? Most of them do telephone consultations and you might be able to get somewhere without waiting until Thursday.
Oh, and to continue the nagging ( my specialist subject according to lordalex ) I think you waited far too long to go to the GP in the first place.
Do hope you feel much better soon. :-))

[islasmum]

I'm also type 2 diabetic and several years ago I had a kidney infection and developed gingivitus as well - I had the very sore mouth, ulcers, absolute agony to try to eat or drink anything - also it was very difficult to take tablets. I'd see your GP again. I can't remember what antibiotics finally did the trick, I'm afraid - it was quite a while ago. Hope you feel better really soon!

[bravejordy]

Thanks again, ladyalex and islasmum. I'm the first to admit I probably left it too long but when you've had as many UTIs as I've had and you know your GP's going to prescribe the same old antibiotics that will only temporarily relieve the symptoms, you start asking yourself: What's the use?

The good news is my mouth seems to be a lot less painful since I took sqad's advice and sucked on ice cubes. Funnily enough, yesterday I was thinking that ice cream might soothe it, but of course I'm diabetic so that's out of the question (and diabetic ice cream is vile!) Honestly, I wasn't trying to be brave, the ice cubes soothed it enough that I didn't need painkillers.

Also, after following the invaluable advice given here, I decided to check out sqad's theory that it might be stomatitis and after a little Internet research (Google) I've come to the conclusion that what I have is actually Denture Stomatitis. What I failed to mention is that I had a partial denture fitted in February and to be fair, it's never given me any trouble, in fact I haven't worn it for about two weeks (since the onset of my latest UTI) so I didn't relate it to my sore mouth. But this is what I found:

Q: What is denture stomatitis (Thrush)?

A: It is a yeast/fungus called candida or thrush, which causes an infection in the mouth. It is not a type of infection that can be passed on to others because everybody has some thrush in their mouths, even babies. It is possible to get thrush elsewhere.

Q: Who can get denture stomatitis?

A: Denture wearers are the most common group to be affected along with people who have difficulties in keeping their mouth clean. Diabetics and anyone who takes steroids either through inhalers or by mouth may also have problems. Some antibiotics are responsible for causing thrush and many people find that taking certain antibiotics encourages a recurrence of infection, especially if taken over a long period of time.

So I think I can safely say we've found the culprit: Trimethoprim (they should change the name to "Try my patience" LOL)

Thanks again

[ladyalex]

Hi bravejordy....nagging again....i still think you need to go to your GP for an anti-fungal prescription as I do not think the thrush will clear up without it.
Or telephone him/ her and see if you can get them to leave a script for you to collect.
Next time you have a UTI, can't you see another GP, or make it quite clear that Trimethoprim is not for you ? or both...
Glad you are feeling a bit better at least.
Just another thought....you might ask your friendly local pharmacist for his/her advice about your mouth.

[bravejordy]

Hi ladyalex, I'm glad to say my mouth is ok now, and the soreness has completely gone away, but now I have something else to worry about. Yesterday I phoned my doctor's surgery to get the results of my urine sample and to see if I was on the correct antibiotics. Anyway the nurse I spoke to told me I have a real nasty infection, she told me the name of it but I can't for the life of me remember what she said it was called and I didn't have a pen handy at the time. All I can remember is it begins with the letter "C" but it definitely wasn't cystitis. I'm thinking it might have been Clostridium but I can't be sure but I have to visit the surgery today anyway so I'll ask the nurse to write it down for me. I'll get back to you on that one. My GP has decided I should continue taking Trimethoprim for a further 3 days, hence the reason I need to go there this morning, to pick up the prescription. To be honest, I wouldn't see any other GP because I feel he's the best one at the practice. FYI, my doctor has recently been named GP of the Year by the Mersey faculty of the Royal College of General Practitioners and received a prestigious award for his dedication. So, I'll pass on your suggestion to see another GP. Also, like I said, I'm due to see the Urologist at the end of the month so I'm not exactly letting the grass grow under my feet. I'll find out for sure what the infection is that I've got and post back later this afternoon. Thanks again for your concern and all your advice, I appreciate your input.

[Sqad]

Thanks for the input....."C".....E.Coli is the commonest.
Citrobacter can also be a problem.

Like you it p1sses me off to see the very common advice on AB to "change your doctor" it is very rarely the doctor who is is at fault..........

[bravejordy]

Cheers sqad, Just got back from the surgery after finding out what I actually have is something called Klebsiella. My apologies for leading you up the garden path by saying it begins with the letter "C" but in my defence, "K" does sound a lot like "C"

[ladyalex]

Sorry to upset you sqad. It certainly wasn't my intention.
Probably our experiences of doctors are different.
I find that they make mistakes sometimes, you clearly have only ever seen perfect ones.
If I had told a GP that a particular medication made me ill, I would expect him to change it or give me a reason why not.
If this didn't happen, I'd ask to see a different partner.

[Sqad]

ladyalex.....my comment was not aimed at YOU, but to all "the "doctor bashers."...;-)

\\\\\I find that they make mistakes sometimes, you clearly have only ever seen perfect ones\\\\

Doctors are human and like humans do make mistakes. I certainly have made thousands and so has EVERY practicing doctor, but if our mistakes were not brought to light. then we would never learn, that it why I get so angry with people "changing their doctor" or even worse, not giving feedback on AB.

Our intimate and unique relation still persists ladyalex...;-)

jordy....Ah! our old friend Klebsiella

[bravejordy]

sqad, I've been reading a lot of worrying stuff about this klebsiella, such as "Klebsiella-caused urinary tract infections are resistant to many antibiotics and sometimes need to be treated with a combination of antibiotics."

My biggest concern is whether Trimethoprim will be enough to nip this thing in the bud. I've been taking them for eight days now, and to be fair they have greatly reduced the symptoms but I still don't feel 100%. I'm on a 10-Day course of Trimethoprim and I have a feeling all the symptoms will return as soon as I stop taking them. And before ladyalex starts nagging me (LOL), I've already made an appointment to see my GP to coincide with when I finish them. He's also asked me to bring a urine sample with me, so between him and the practice nurse, they are closely monitoring the situation.


On a more serious note, I do have the greatest of respect for my GP and I think when it comes to Urinary Tract Infections any GP worth his salt is going to prescribe a course of antibiotics as a first line of defence, which is quite understandable. I don't think by going to see a different GP would mean I'd be prescribed some "wonder drug" to make all my problems go away. Plus, I think in a lot of cases it's more down to patient error than doctor error. Like I said a few posts back, I've had so many UTIs during the last three years (and four this year alone) that it's got to a stage where I no longer rush to see my GP as soon as an infection comes on. I know I should (and in the light of this klebsiella, I probably will from now on) but I can hardly hold my GP accountable for my own failings. For instance, I've lost count of the number of times I've come away from my doctor's surgery and thought "Oh dear, I forgot to tell him about such-and-such a symptom" and for all I know, that particular symptom could have been vital to the diagnosis. After all, GPs can only work with what we tell them, they're not mind readers.

[Sqad]

jordy.....LOL....you are quite a philosopher.

Klebsiella can be a nuisance in the urinary tract and as you say can be resistant to many antibiotics and is better treated with a combination.

You are taking Trimethoprim and improving clinically (if we ignore your relapses).

I do not know the sensitivity of the Klebsiella to Trimethoprim,but when the organism was cultured, it would have been checked against a range of antibiotics and as your GP suggested that you continue on this regime then one can reasonably assume that you are on the correct antibiotic.

Interesting.......keep us informed.

[ladyalex]

sqad....xxx

jordy...crawler LOL

Hope you feel better very soon :-))