Dear Dr. Donohue: Please discuss the relationship between bad breath and liver and kidney problems -- diagnosis, treatment and cure. -- D.H.
Dear D.H.: Nine times out of 10, people need not implicate the liver or kidney as the source of bad breath. Its source can usually be found in the mouth.
An overgrowth of mouth bacteria converts food into sulfur compounds that are the olfactory equivalents of rotten eggs.
Ridding the mouth of bacteria usually also rids the mouth of unpleasant breath. Floss religiously. Brush the tongue with toothpaste every time you brush the teeth. If you are not one who easily gags, gently scrape the back of the tongue with a plastic spoon turned upside down.
A dry mouth also spawns mouth odors. Don't let the mouth hang open during sleep. Ask your spouse if it does. If the answer is yes, keep it closed by looping an elastic band under the chin and over the head.
Meat assists mouth bacteria in production of foul-smelling sulfur compounds. Cut down on meat and increase portions of grains, vegetables and fruits.
Liver and kidney disease can impart a noxious odor to the breath. However, other symptoms of liver and kidney failure are so florid that the diagnosis of their failure is rarely missed. Bad breath by itself rarely indicates liver or kidney problems.
The dentist can aid you in a program to eradicate stubborn mouth bacteria. Some people require prescription mouthwashes to decimate those bacteria.
Dear Dr. Donohue: My neighbor has recently been diagnosed with meralgia paresthetica. Please be good enough to offer an explanation of this disease, its treatment and the prognosis. -- E.P.
Dear E.P.: "Disease" is too strong a word for meralgia paresthetica. "Condition" fits the bill better.
It's the result of pressure on a nerve located on the side of the body at about the belt line.
Pressure on the nerve produces numbness or burning pain on the front and side of the thigh. Pressure can come from skintight jeans, too snug a belt or excess fatty tissue. People with diabetes can develop meralgia paresthetica due to diabetes damage to the nerve.
If weight is the problem, dieting is the answer. If constricting garments are the cause, the answer is obvious.
However, there are times when the doctor is at a loss to identify a cause. Then cortisone shots along the path of the nerve can eliminate inflammatory swelling that might be compressing it.
If pain persists, surgically freeing the nerve from entrapping tissues almost always puts an end to the problem.
Write to Paul Donohue, M.D., P.O. Box 5539, Riverton, NJ 08077-5539.