Continuing to try to figure out my aphthous ulcers

January 24, 2017 12:11 AM

Previously I asked for help breaking a nasty streak of canker sores. The twist: They went away. On their own. For nine months.

Yes, for the glorious duration of my pregnancy I had not a single sore. And then, a mere two days after I delivered, they were back.

So now it's time to go get all those tests done from the previous post, but before I do so I want to know if the magic pregnancy cure suggests anything further about the possible underlying causes of the problem.

Does this mean it could be hormonal? Can I do something to replicate the hormone cocktail in question? I've had sores both when on and off hormonal BC...

Should I just be taking prenatal supplements forever? This seems unlikely, because I took them for four months before getting pregnant due to a small, harmless misunderstanding about the difference between "only folic acid supplements" and "supplement everything!" - in fact, given that the problem peaked during that time maybe it's connected to an over abundance of something in those pills? And then, uh, as soon as I delivered I... Had an overabundance again?

Or is this just related to the "fetus affects mother's immune system" thing and the sores are a bug in my immune system? CAN I FIX THAT BUG (sans a fetus)?

Are there ways for me to test these hypotheses?

I'm really tired of doctors just sort of shrugging and giving me the same ineffective anaelgesics every time I try to address this problem, so I really want a list of things I can try to do to isolate and fix the cause...

posted by Cozybee to Health & Fitness (7 answers total)

From my pessimistic anecdotal perspective (and as someone who got relief from several autoimmune conditions while pregnanat), the latter was true - nothing has ever, ever worked for me other than painting them with Kanka and waiting for them to go away (in my younger days, it helped to have a beer immediately when coming home from work, but I can't fit that into my lifestyle anymore).
posted by Pax at 1:27 AM on January 24, 2017

Can't help with the pregnancy factor, but my mouth ulcers went away completely when I started taking a B6/B12/folic acid supplement for other reasons.
posted by une_heure_pleine at 2:42 AM on January 24, 2017 [1 favorite]

Epidemiologist chiming in. Since the '60s, we've known that people with recurrent canker sores tend to have higher amounts of antibodies against cow's milk proteins in their blood. Just a few years ago, a study finally quantified this phenomenon. This isn't the only trigger for canker sore development, but it seems to be a significant one, at least among the population examined (50 people with recurrent canker sores and 50 people without, in Serbia). If you consume dairy (specifically, milk or cheese made from cow's milk), have you tried cutting them out of your diet for 2-4 weeks (or longer)?
posted by late afternoon dreaming hotel at 8:33 AM on January 24, 2017 [6 favorites]

I used to get cankers all the damn time, as in I would go around telling people my mouth hurt. Dr. Google suggested that an ingredient in regular toothpaste, sodium lauryl sulfate, is somehow linked to canker sores. (It's a foaming agent, apparently.) So I started reading the labels and now I use the store-brand version of Sensodyne, which doesn't have sodium lauryl sulfate. Thereafter I got cankers less often, but they haven't gone away entirely. My dentist gives me a prescription for acyclovir, an antiviral, which doesn't keep me from getting them but significantly lessens the duration and frequency. I take it when I feel one coming on, and take it until I don't feel the sore anymore. It's a world of difference, I'm telling you.
posted by scratch at 8:45 AM on January 24, 2017

Purely anecdotal, but mine went away after I started treatment for celiac disease (i.e. a gluten free diet). Previous to that, I had found that limiting SLS in toothpaste seemed to help, but not eliminate them. I don't think celiac caused them, but I think the rampant inflammation my body was undergoing due to an undiagnosed autoimmune disease probably contributed. If you have any other autoimmuney symptoms, checking into them might be worth pursuing with your doctor.

The theory about vitamins mentioned by une_heure_pleine could also explain why they went away for me (celiac affects your ability to absorb nutrients properly).

Maybe make a list of things to try and be systematic about it? Keep notes on how often you have them for a month, then add in or try another thing?

Good luck. I remember how much those could hurt. :(
posted by purple_bird at 8:57 AM on January 24, 2017

Dentist chiming in. As you've no doubt found, and this thread will bear out, there is no one cause, and no one treatment for what we call aphthous stomatitis. I am not your dentist, and haven't had the opportunity to definitively diagnose your case, so take my advice as simply that, and see a dentist if your symptoms get worse or change.
Your pregnancy protected you for those months, but recreating those conditions will be a challenge. Perhaps it was less stress, perhaps different diet, likely increased hormones and immune system changes.
Stress, diet and toothpaste are the first things I look to. Try to see if you can find a pattern, maybe keep a diary (patients are sometimes surprised to find that they didn't realize they ate strawberries 3 days before each breakout, it's rare but it happens).
SLS is not the only ingredient in toothpastes that can be troublesome, so look for one with the fewest additives (stay away from whitening, anti-tartar, and pro-enamel types).
If you are going to eliminate specific foods and dairy, do so for at least several weeks in order to know.
Try to reduce stress (I know it's not easy, but stress is a factor).
Since there are some systemic diseases that have similar symptoms, it's not unreasonable to rule them out as well.


I have found the best topical remedy is Orabase with benzocaine. it's a thicker paste that stays around longer and provides a protective barrier while healing.
posted by OHenryPacey at 9:45 AM on January 24, 2017 [4 favorites]

Did you take antacids for heartburn during your pregnancy? I had painful heartburn that started in the second trimester and abruptly ended after delivery. My OB prescribed Zantac, which just turned that heartburn off like a switch. Was so much more effective than taking Tums all day. Maybe reducing acid in stomach helps with canker sores, however I never had those. I know many women suffer from bad heartburn, though, so I thought I'd ask.
posted by waving at 6:37 AM on January 25, 2017