xerostomia

Saliva, or spit, is made by your salivary glands. It helps keep you and your mouth healthy. For example:

• It moistens and breaks down the foods you eat, which makes it easier for you to chew and swallow.
• It washes away small food pieces from your teeth and gums, which helps fight against tooth decay.
• It contains minerals such as calcium and phosphate, which can also help fight tooth decay.
• It contains antibodies that can fight against infections of the mouth and throat. Antibodies are proteins that your immune system makes to fight foreign substances such as viruses and bacteria.

Having dry mouth, also called xerostomia, means that you don't have enough saliva to keep your mouth wet. Everyone has a dry mouth once in a while, like when you are nervous or stressed. But if you have a dry mouth all or most of the time, it can be uncomfortable. It can make chewing, swallowing, and even talking difficult. It also raises your risk for tooth decay or infections in the mouth.

There are many possible causes of dry mouth, including:

• Side effects of certain medicines, such as some medicines for high blood pressure, depression, and bladder-control issues
• Diseases such as Sjogren's syndrome, HIV, salivary gland disorders, and diabetes
• Radiation therapy, which can damage your salivary glands if they are exposed to radiation during the treatment
• Chemotherapy, which can make your saliva thicker and cause your mouth to feel dry
• Nerve damage, when it involves the nerves that tell salivary glands to make saliva
• Breathing through your mouth
• Use of alcohol, tobacco, or other substances

The symptoms of dry mouth may include:

• A sticky, dry feeling in your mouth
• Trouble chewing, swallowing, tasting, or speaking
• A burning feeling in your mouth
• A dry feeling in your throat
• Cracked lips
• A dry, rough tongue
• Mouth sores
• An infection in your mouth
• Bad breath

If you have dry mouth, it's important to find out the cause. To do that, your health care provider or dentist will review your medical history, examine your mouth, and ask about any medicines you take. They may also suggest blood tests or a test that measures how much saliva you produce.

Treatment for dry mouth depends on the cause. For example, if a medicine is causing dry mouth, your provider or dentist may suggest adjusting the dosage or switching medicines. In some cases, they might give you artificial saliva or a medicine to help your salivary glands work better.

There are also several things you can do to help relieve your symptoms:

• Drink plenty of water
• Avoid drinks with caffeine, which can dry out your mouth
• Chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow
• Avoid spicy or salty foods because they can cause pain if your mouth is dry
• Avoid alcohol and tobacco
• Using a humidifier at night
• Use a mouthwash made for dry mouth

Since dry mouth can raise your risk of tooth decay, it's important to brush and floss your teeth regularly and see your dentist at least twice a year.

NIH: National Institute of Dental and Craniofacial Research

Sjogren's syndrome, also called Sjogren's disease, is a chronic (long-lasting) autoimmune disease. When you have an autoimmune disease, your immune system attacks healthy tissues and organs by mistake. In Sjogren's syndrome, your immune system attacks the glands that make moisture in the eyes, mouth, and other parts of the body. This causes a dry mouth and dry eyes. You may have dryness in other places that need moisture, such as your nose, throat, and skin. Sjogren's can also affect other parts of the body, including your joints, lungs, kidneys, blood vessels, digestive organs, and nerves.

Normally, your immune system protects the body from infection and disease. But with Sjogren's syndrome and other autoimmune diseases, your immune system attacks healthy tissues and organs. Researchers don't know for sure what causes the immune system to do this. But they think that it is caused by a combination of genetic and environmental factors. Studies have linked Sjogren's syndrome to gene changes in several genes. Some researchers also think that the disease may be triggered by something in the environment. For example, they think that one possible trigger could be a previous infection with a virus or bacteria.

Most people with Sjogren's syndrome are women. You can get it at any age, but it is most common in people in their 40s and 50s.

Sjogren's syndrome is more common in people who have other autoimmune diseases such as rheumatoid arthritis and lupus. This is known as a secondary form of Sjogren's syndrome. People who don't have another autoimmune disease have a primary form of Sjogren's syndrome.

Sjogren's syndrome may have different effects on the body. Not everyone will have the same symptoms. Some people have cycles of mild and then severe symptoms.

The two main symptoms are:

• Dry eyes. Your eyes may burn or itch or feel like they have sand in them. Sometimes your vision may be blurry, or you could be bothered by bright lights.
• Dry mouth. Your tongue and your throat may feel dry. You might have trouble swallowing, speaking, and tasting.

Sjogren's syndrome can also affect other parts of the body, causing symptoms such as:

• Joint and muscle pain
• Dry skin
• Rashes on the skin of hands or feet
• Numbness or tingling in the hands or feet
• Vaginal dryness
• Dry cough that doesn't go away
• Fatigue that doesn't go away

There is no single test for Sjogren's syndrome. To find out if you have it, your provider:

• Will ask about your medical history and symptoms.
• Will do a physical exam, which includes checking for signs of dry mouth and signs of related autoimmune diseases.
• May order tests, including:
  • Eye tests to see if you produce a normal amount of tears and to find out if your eyes have been damaged by dryness.
  • Salivary gland tests to measure how much saliva your mouth produces. They could include imaging tests and a biopsy.
  • Blood tests.

There is no cure for Sjogren's syndrome. Treatment focuses on relieving your symptoms. The treatments can be different for each person, depending on which parts of the body are affected. They may include:

• Eye drops (artificial tears) or ointments to relieve dryness in the eyes.
• Saliva substitutes.
• Prescription medicines that cause your salivary glands to make more saliva.
• A minor procedure that places small plugs the tear duct in the corners of the eyes. The plugs block your tears from draining so they stay in your eyes longer.
• Medicines to help with other symptoms caused by Sjogren's syndrome, such as medicines for pain and inflammation.
• Medicines that suppress (weaken) your immune system (for severe cases).

You can also try to relieve some of your symptoms by sucking on sugar-free candy, drinking water often, increasing the humidity in your room, and not smoking. Because having a dry mouth can raise your risk of cavities, it's important to take good care of your teeth and see your dentist regularly.

Dehydration is a condition caused by the loss of too much fluid from the body. It happens when you are losing more fluids than you are taking in, and your body does not have enough fluids to work properly.

You can become dehydrated because of:

• Diarrhea
• Vomiting
• Sweating too much
• Urinating too much, which can happen because of certain medicines and illnesses
• Fever
• Not drinking enough water or other fluids

Certain people are more likely to develop dehydration:

• Older adults. Some people lose their sense of thirst as they age, so they don't drink enough fluids.
• Infants and young children, who are more likely to have diarrhea or vomiting
• People with chronic illnesses that cause them to urinate or sweat more often, such as diabetes, cystic fibrosis, or kidney problems
• People who take medicines that cause them to urinate or sweat more
• People who exercise or work outdoors during hot weather

In adults, the symptoms of dehydration include:

• Feeling very thirsty
• Dry mouth
• Urinating and sweating less than usual
• Dark-colored urine
• Dry skin
• Feeling tired
• Dizziness

In infants and young children, the symptoms of dehydration include:

• Dry mouth and tongue
• Crying without tears
• No wet diapers for 3 hours or more
• A high fever
• Being unusually sleepy or drowsy
• Irritability
• Eyes that look sunken

Dehydration can be mild, or it can be severe enough to be life-threatening. Get medical help right away if the symptoms also include:

• Confusion
• Fainting
• Lack of urination
• Rapid heartbeat
• Rapid breathing
• Shock

To find out if you dehydration, your health care provider will:

• Do a physical exam
• Check your vital signs
• Ask about your symptoms

Your provider may also order tests, such as:

• Blood tests to check your electrolyte levels, especially potassium and sodium. Electrolytes are minerals in your body that have an electric charge. They have many important jobs, including helping to keep a balance of fluids in your body.
• Blood tests to check your kidney function.
• Urine tests to check for dehydration and its cause.

The treatment for dehydration is to replace the fluids and electrolytes that you have lost. For mild cases, you may just need to drink lots of water. If you lost electrolytes, sports drinks may help. There are also oral rehydration solutions for children. You can buy those without a prescription.

Severe cases may be treated with intravenous (IV) fluids with salt in a hospital.

The key to preventing dehydration is making sure that you get enough fluids:

• Drink enough water every day. Each person's needs can be different, so ask your health care provider how much you should be drinking each day.
• Avoid drinks that have sugar and caffeine.
• Drink extra fluids when the weather is hot, especially if you are exercising or working outside. If you are losing a lot of minerals in sweat, sports drinks can help you. But some sports drinks have lots of sugar, so be careful not to drink too much of them.
• Get extra fluids when you are sick. If you are having trouble keeping liquids down, you can try taking small sips of water or sucking on ice chips.

Gastroenteritis is an inflammation of the lining of the stomach and intestines. The main symptoms include vomiting and diarrhea. It is usually not serious in healthy people, but it can sometimes lead to dehydration or cause severe symptoms.

There can be many different causes of gastroenteritis:

• Viruses
• Bacteria
• Parasites
• Chemicals
• Reactions to certain medicines and food

Viral gastroenteritis is the most common type. It can be caused by many different viruses, including noroviruses and rotaviruses. Some people call viral gastroenteritis the "stomach flu." But this name is not medically correct. It is not caused by flu viruses. The flu is a respiratory infection that affects your nose, throat and lungs.

When gastroenteritis is caused by consuming foods or drinks contaminated with viruses, bacteria, parasites, or chemicals, this is called food poisoning.

The viruses, bacteria, and parasites that cause gastroenteritis can also spread from person to person. You could be infected when you touch something that has the germs on it and then touch your eyes, mouth, or nose.

The symptoms of gastroenteritis include:

• Diarrhea
• Pain or cramping in your abdomen (belly)
• Nausea
• Vomiting
• Sometimes fever

Gastroenteritis is usually not serious. But it can sometimes cause lead to dehydration or cause severe symptoms. Certain people are at higher risk for these problems. They include:

• Pregnant women
• Older adults
• People with weakened immune systems or other serious health conditions
• Infants
• Babies who were born prematurely or have other health conditions

If you or a family member are at higher risk and have symptoms of gastroenteritis, contact a health care provider right away. Even if you are not at high risk, it is possible to become dehydrated or have more serious symptoms. There are some warning signs to watch for. It's important to contact a provider right away if you or your child have any of them:

• For adults, they include:
  • Change in mental state, such as irritability or lack of energy
  • Diarrhea lasting more than 2 days
  • High fever
  • Vomiting often
  • Six or more loose stools in a day
  • Severe pain in the abdomen (belly) or rectum
  • Stools that are black and tarry or contain blood or pus
  • Symptoms of dehydration, such as thirst, dry mouth, headache, dark-colored urine, and urinating less than normal
• For infants and children, they include:
  • Change in the child's mental state, such as irritability or lack of energy
  • Diarrhea lasting more than a day
  • Any fever in infants
  • High fever in older children
  • Frequent loose stools
  • Vomiting often
  • Severe pain in the abdomen (belly) or rectum
  • Signs or symptoms of dehydration, such as thirst, dry mouth, urinating less than usual or no wet diapers for 3 hours or more, and no tears when crying
  • Stools that are black and tarry or contain blood or pus

To find out if you have gastroenteritis, your provider:

• Will do a physical exam
• Will ask about your symptoms
• May do tests of your stool

Usually, people with gastroenteritis get better on their own, with rest and plenty of fluids and electrolytes. Your provider may suggest that you take a probiotic. Studies suggest that some probiotics may help shorten a case of diarrhea.

People with more severe symptoms may need medicines to control nausea or vomiting. Providers may also give other medicines for certain types of gastroenteritis, such as antibiotics for some bacterial types and antiparasitic medicines for some parasitic types.

Gastroenteritis cannot always be prevented. But proper hand washing, cleaning surfaces that may be infected with germs, and safe food preparation may help prevent some of the infections that can cause gastroenteritis. There are vaccines for infants to protect against rotavirus infections.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Overactive bladder is a condition in which the bladder squeezes urine out at the wrong time. You may have overactive bladder if you have two or more of these symptoms:

• You urinate eight or more times a day or two or more times at night
• You have the sudden, strong need to urinate immediately
• You leak urine after a sudden, strong urge to urinate

You also may have incontinence, a loss of bladder control. Nerve problems, too much fluid, or too much caffeine can cause it. Often the cause is unknown.

Your doctor may prescribe a medicine that can calm muscles and nerves. The medicine may come as a pill, a liquid, or a patch. The medicines can cause your eyes to become dry. They can also cause dry mouth and constipation. To deal with these effects, use eye drops to keep your eyes moist, chew sugarless gum or suck on sugarless hard candy if dry mouth bothers you, and take small sips of water throughout the day.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Adenoids are a patch of tissue that is high up in the throat, just behind the nose. They, along with the tonsils, are part of the lymphatic system. The lymphatic system clears away infection and keeps body fluids in balance. The adenoids and tonsils work by trapping germs coming in through the mouth and nose.

Adenoids usually start to shrink after about age 5. By the teenage years, they are almost completely gone. By then, the body has other ways to fight germs.

Enlarged adenoids are adenoids that are swollen. It is a common problem in children.

Your child's adenoids can be enlarged, or swollen, for different reasons. It may just be that your child had enlarged adenoids at birth. Adenoids can also become enlarged when they are trying to fight off an infection. They might stay enlarged even after the infection is gone.

Enlarged adenoids can make it hard to breathe through the nose. Your child might end up breathing only through the mouth. This may cause:

• A dry mouth, which can also lead to bad breath
• Cracked lips
• A runny nose

Other problems that enlarged adenoids can cause include:

• Loud breathing
• Snoring
• Restless sleep
• Sleep apnea, a disorder that causes you to repeatedly stop breathing during sleep
• Ear infections

To find out if your child has enlarged adenoids, the health care provider will:

• Ask about your child's medical history, including asking about your child's symptoms
• Check your child's ears, throat, and mouth
• Feel your child's neck

Since the adenoids are higher up than the throat, the provider cannot see them just by looking through your child's mouth. To check the size of your child's adenoids, your provider may use:

• A special mirror in the mouth
• A long, flexible tube with a light (an endoscope)
• An x-ray

The treatment depends on what is causing the problem. If the symptoms are not too bad, your child may not need treatment. If treatment is needed, your child may get nasal spray to reduce the swelling or antibiotics if the provider thinks that there is a bacterial infection.

In some cases, your child may need an adenoidectomy.

An adenoidectomy is surgery to remove the adenoids. The provider may recommend this surgery if:

• Your child has repeated infections of the adenoids. Sometimes the infections can also cause ear infections and fluid buildup in the middle ear.
• Taking antibiotics doesn't get rid of a bacterial infection of the adenoids.
• The enlarged adenoids block the airways.

If there is also a problem with the tonsils, your child will probably have a tonsillectomy (removal of the tonsils) at the same time that the adenoids are removed.

After having the surgery, your child usually goes home the same day. Your child will probably have some throat pain, bad breath, and a runny nose. It can take several days to feel all better.

A caregiver gives care to someone who needs help taking care of themselves. It can be rewarding. It may help to strengthen connections to a loved one. You may feel fulfillment from helping someone else. But sometimes caregiving can be stressful and even overwhelming. This can be especially true when caring for someone with Alzheimer's disease (AD).

AD is an illness that changes the brain. It causes people to lose the ability to remember, think, and use good judgment. They also have trouble taking care of themselves. Over time, as the disease gets worse, they will need more and more help. As a caregiver, it is important for you to learn about AD. You will want to know what happens to the person during the different stages of the disease. This can help you plan for the future, so that you will have all of the resources you will need to be able to take care of your loved one.

As a caregiver for someone with AD, your responsibilities can include:

• Getting your loved one's health, legal, and financial affairs in order. If possible, include them in the planning while they can still make decisions. Later you will need to take over managing their finances and paying their bills.
• Evaluating their house and making sure it's safe for their needs
• Monitoring their ability to drive. You may want to hire a driving specialist who can test their driving skills. When it is no longer safe for your loved one to drive, you need to make sure that they stop.
• Encouraging your loved one to get some physical activity. Exercising together may make it more fun for them.
• Making sure that your loved one has a healthy diet
• Helping with daily tasks like bathing, eating, or taking medicine
• Doing housework and cooking
• Running errands such as shopping for food and clothes
• Driving them to appointments
• Providing company and emotional support
• Arranging medical care and making health decisions

As you care for your loved one with AD, don't ignore your own needs. Caregiving can be stressful, and you need to take care of your own physical and mental health.

At some point, you will not be able to do everything on your own. Make sure that you get help when you need it. There are many different services available, including:

• Home care services
• Adult day care services
• Respite services, which provide short-term care for the person with AD
• Federal and state government programs that can provide financial support and services
• Assisted living facilities
• Nursing homes, some of which have special memory care units for people with AD
• Palliative and hospice care

You might consider hiring a geriatric care manager. They are specially trained professionals who can help you to find the right services for your needs.

NIH: National Institute on Aging

There are many reasons why you might have bad breath. You can get it if you don't brush and floss regularly. Bacteria that build up in your mouth and between your teeth produce the bad odor. Other problems in your mouth, such as gum disease, dry mouth, or cavities, may also cause it. Sinusitis or problems with your nose may be to blame. You can also have bad breath if you eat some foods, like raw onions, garlic, or cabbage. And of course smoking causes its own bad smell. Some diseases and medicines can cause a specific breath odor.

Having good dental habits, like brushing and flossing regularly, help fight bad breath. Mouthwashes, mints or chewing gum may make your breath fresher. If you have a disease that causes the bad breath, treating the disease may help give you fresher breath.

Botulism is a rare but serious illness. The cause is a toxin (poison) made by a bacterium called Clostridium botulinum. It occurs naturally in soil.

There are several kinds of botulism. Foodborne botulism comes from eating foods contaminated with the toxin. Wound botulism happens when a wound infected with the bacteria makes the toxin. It is more common in heroin users. Infant botulism happens when a baby consumes the spores of the bacteria from soil or honey. All forms can be deadly and are medical emergencies.

Symptoms include double or blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, and muscle weakness. Treatment may include antitoxins, intensive medical care, or surgery of infected wounds.

To prevent botulism:

• Be very careful when canning foods at home
• Do not let babies eat honey
• Get prompt medical care for infected wounds

Centers for Disease Control and Prevention

Cancer is a common disease. Almost 40 percent of Americans will be diagnosed with cancer during their lifetimes. Even though cancer may be life-threatening, many people have successful treatment. Others live with cancer for a very long time.

For most people with cancer, learning to live with the disease is one of the biggest challenges they've ever faced. That's because having cancer touches just about every part of your life and the lives of those around you.

Cancer and its treatment may change:

• Your daily routines and ability to work
• Your important relationships
• The way you look, feel, and think about yourself

You may feel more in control and prepared to cope with these changes if you learn about what to expect. Your health care provider can help you find information and support services that are right for you.

Having cancer may cause a range of strong emotions, such as sadness, anger, fear, worry, or guilt. These feelings are normal, and they're likely to change over time. It's helpful to sort out your feelings in a way that's comfortable for you. You might try:

• Talking openly with someone you trust
• Writing about your feelings
• Using relaxation methods, such as meditation and other complementary and alternative medicine (CAM)
• Doing things you enjoy to give yourself a break from focusing on cancer

If your emotions seem to take over your life, tell your provider. You may need extra support if you have symptoms of depression, stress, anxiety, or panic disorder.

During cancer treatment, you usually have a team of providers. Along with doctors and nurses, you may be able to talk with social workers, pharmacists, dietitians, and other health professionals.

These professionals are prepared to help you deal with the issues that cancer brings up, including concerns about finances. But it's up to you to let your team know what's on your mind.

Good communication with your providers may help you feel more in control and satisfied with your care. Your communications may be better if you:

• Tell your providers how much you want to know about your cancer and its treatment. Do you want all the details or just the big picture?
• Write down your questions and concerns before your visits.
• Bring a family member or a friend to your visits. This person can help by listening, taking notes, and asking questions.

Cancer changes the daily routines and roles of the people who love and support you. They may need to start doing the things you've always done for them. And you may need their help doing things you've always done for yourself. These changes can be difficult for everyone.

It may help to have an honest talk about changing roles and needs. If that sounds too difficult, ask a social worker or other member of your care team to help you talk with family and friends who are helping with your care. These caregivers may need some support, too.

Cancer and its treatment may cause some big changes in how you look, feel, and think about yourself. For example, you may have:

• Less energy
• Temporary or permanent changes in your body, such as scars, or hair loss from chemotherapy
• Problems being sexually close or doubts about dating

Coping with these changes can be hard. But most people find ways to feel more positive over time. If you feel well enough, you might try:

• Exercise. Walking, yoga, or other movement may help you feel stronger and more in control of your body. But check with your provider first.
• Staying involved in life and helping others. Think about volunteering, hobbies, or other activities that might make you feel good about yourself.
• Counseling for sexual problems. Talking with a professional, either with a partner or on your own, may help.

After treatment, you'll have regular cancer follow-up care. Your provider will explain the schedule of checkups and tests you'll need. This is a good time to discuss the challenges you may face ahead. Knowing what to expect may help you make plans as you find a "new normal" with cancer as part of your life.

NIH: National Cancer Institute