instruction: hello doctor I am a 42 year old male my height is 1 and I weigh about 120 keg I do not do any exercise just a month ago I experienced painful stomach cramps diarrhea excessive gas sweating and belching with bad taste which lasted for one night I rested up for two days and felt much better but a cold sore appeared on my lip which again only last a few days I am not sure if it is related but quite shortly the aforementioned incident I noticed enlarged papillae slightly apart from the others I was naturally curious so rubbed it with my finger and it did not feel any pain so I just forgot about that shortly after I started to feel pain in my tongue the pain would change location throughout the day and often move to my hard palate I then noticed my tongue appeared white coated I started to use oral thrush lozenges rinse my mouth with mouthwash gargle with warm water and salt brush my teeth and tongue before bed I never used to after a few weeks my tongue appeared pinker but the pain is still on and off I finished the lozenges hoping that would be the end of it but I have noticed today that my tongue again appears white coated and I now feel sore on the hard plate near the front teeth also a new cold sore has appeared I have read and looked at the photos about oral thrush hairy tongue and so on but really I have no idea what my condition is I have not been to see a doctor or dentist because quite honestly I am very scared reading that white coated tongue causes can be anything from excessive alcohol tobacco use right through to hiv or cancer is simply terrifying me I did purchase a diabetes home test kit urine which did not show any traces I drink and vape once a week but on that day I consume both excessively please shed some light and guidance photos run in chronological order
output: hi first of all thank you for the detailed history of your symptoms and photos which you have attached before I discuss further about possible diagnosis let me assure you that your symptoms or the photos you have sent do not show anything sinister in your mouth or tongue analysis of your symptoms are suggestive of a condition known as laryngopharyngeal reflux disorder lprd where backflow of digestive acid causes significant injury to throat and mouth structures including tongue and palate in your case symptoms seems to be triggered by an initial attack of acute gastritis and reflux which may have caused significant injury acid can injure tongue papillae causing a coating of tongue multiple small ulcerations inflammation of tongue papillae if the reflux continues to occur it can keep injuring different areas of tongue and mouth leading to migration of symptoms occasional binge drinking and vaping seems to be causing further damage to already injured tissue you may need to take a few week course of anti reflux medications and avoid drinking and vaping while on treatment to facilitate the healing process other than this I do not see anything dangerous as per the photos you have attached also it does not look like oral thrush oral candidiasis so antifungal lozenges may not be of much use