22 month old- ulcer agony

[Alley22]

My son is in agony - he has over 10 mouth ulcers against his bottom lip and I when I looked yesterday he has white spots under his tongue and down the back of his throat. He is in so much pain. The doctor said there is nothing she can do to help him, just apply bonjela (which is okay for those on his lips and inside his cheeks) and use Calpol. It would be impossible to reach most of them on his palette and in his throat with Bonjela. He isnt eating, isnt drinking a lot (Ive tried, beakers, straws, spooning it in) he is taking a little ice cream, yoghurt etc as its cold. I gave him finely cut chicken in gravy for dinner last night and he wouldnt eat anything, not even mashed up banana. He is not sleeping and is, as you can well imagine, very irritable and upset. I know how painful it is to have one. Has anyone got any advice??? or will he have to bear it until they go???

You poor thing, I hope someone can help you.

Thanks Sister, sometimes you feel so helpless.. i just want to take the pain away and I cant
I hope someone has some advice.. or has experienced similar..

Oh poor baby and poor you. How old is he? Maybe some sore-throat sweets would numb the pain a bit if he's old enough to suck them? I'd keep going with the ice cream and ice lollies might be soothing too. Milk shakes can be good if you're worried about how much he's eating- throw a banana and a bit of ice cream into full fat milk. I can't really think of anything else, I'm afraid but I do sympathise. I hope they go soon.

Ill take a look in the Chemist, but as hes only 22 months old Im not sure that he would suck them. He has got it into his head that everything I approach him with is medicine, so he closes his mouth up tight, even with food and drinks. Poor lad, I bet when kids feel ill they think they will feel like that forever, whereas - even though we dispair we know they will go eventually..

Is your dr 100% sure it's just ulcers? The white spots sound like thrush. I know that was excruiciating on the nipple so it could be pretty bad in the mouth too. Live yoghurt's obviously your answer there, or I believe they can give you drops (whatever age your ds is).

It helps to dry the ulcer gently with a cotton bud before applying bonjela (although it does hurt a bit) to help it to work, I find on my ulcers. I find salt water gargles help too, but depending on the age of you ds, that might not be an option.

He had such a screaming fit at the doctors and wouldnt let her anywhere near him, so it may have been difficult to see, but I explained exactly what they were and she didnt suggest it, perhaps I should go and see another doctor.

I have to apply the bonjela when he is either asleep or being pinned down (that sounds terrible doesnt it) as he is a strong willful lad and shuts his mouth up tight if he thinks Im about to apply the cream, and I have exhausted the different approaches, magic cream, bribery etc..

Im sorry if this sounds dense , but can you get live yoghurt that is dairy free, he is allergic to milk and eggs, so the yoghurts I usually buy are the Provimal range.

I had the exact same when my DS was 18 months. I took him to the GP about twice - first I was told to use Bonjella and secondly ( because this was so hard to administer ) we were given a spray ( that stung like crazy )

I got to the point that I had lost so much confidence in my GP that I took DS to A&E as he was not feeding / drinking.

They - thankfuly took me seriously and said that he had coldsores in the mouth ( part of the herpes virus ) and he was prescribed Zovirax suspension. By the end of the day he was in alot less pain and the relief was enormous for both of us.

That's my advice and I hope it's of some help. Good Luck

Oh, poor lad, my heart realy goes out to both of you.

I think the treatment for thrush is fairly safe, so it might be worth suggesting it to the doctor even if she can't examine him.
Although, TBH, if the ulcers are as bad as they sound, I think your doctor really ought to see them - she might think it was worth giving him something stronger than bonjela. Do you think you could persuade them to do a home visit when he's napping? Or would you consider getting them to give him something to sedate him first? Is he any more keen to help when he's had a calpol, or does it not take his pain away? (infant ibuprofen might be better if not)

oh Crystaltips.. it all sounds very familiar, I have over the last few months lost a lot of faith in my GP, sometimes I feel they want you in and out within 10 minutes regardless of the problem.

Can I ask what the coldsores looked like? His are white, quite big surrounded by an angry red colour. that is on his lips, then the spots are smaller with white heads, red around those too.

I think I will take him to get a second opinion from the doctor/hospital. He has had these since Monday and has not been drinking well for two days, although oddly enough he is prefering his warm drinks to his cold ones at the moment.

Philippat, I have just tried ringing the doctor and cannot get an appt till next week, I might try your suggestion about a home visit from a doctor on call, perhaps hell feel more comfortable, although its been such a struggle getting him to sleep that I dont think he would stay asleep through an examination!

Im hoping that it wont be too long before these go, Im taking him to the zoo tomorrow to try and distract him from the pain a little, I find distraction the best weapon against pain and frustration and tantrums.. Ill keep u all posted.

Sojasun do a live soya, yoghurt alternative. It isn't as sour as normal plain yoghurt so it shouldn't be too nasty - you could always add fruit puree. It costs around 77p for 250g from health food shops. I'm not sure if Provamel plain Yofu is live but it is the nearest thing in flavour to plain yoghurt.

Thanks PamT, anythings worth a try!

PS: can you get Sojasun from somewhere like Holland and Barratts? I dont recall seeing any alternatives in the supermarkets down my way! tescos have only just started stocking the Provamel range! even then its only one kind, one flavour!LOL bit behind the times..

Crystaltips has the right idea - this sounds like a strain of the herpes virus. If your GP has not ben good - try your dentist for the diagnosis. My sisters dd had the same thing and he presribes a spray that had an anaesthetic effect. Best thing would be Zovirax - not sure if dentist can precribe it. Are you around Jasper for info

Alley, have you tried using the "emergency" word with your doctors receptionist? I know technically it isn't an emergency in terms of sirens and flashing lights and so on but a friend and I talked about this recently and came to the conclusion that both our doctors expect us to use that word to mean "it's a child, he's in agony and I want to see someone TODAY. Please." Could you try calling and going back down there before the weekend? Mine will normally fit us in if I'm pushy enough and explain how bad it is and how worried I am. Good luck.

I know this well... I have started at least 2 threads on this....
Not sure if you will find my post useful as I am a bit "alternative" when it comes to our kids' health

These cold sores are excrutiating but it is a sign that he is run-down (actuall that's what my dentist toldme)...this a way for his body to deal with something else. In the case of DS it tended to be teething (the big teeths).
I never gave him anything (not even calpol) but he got a massive amount of TLC. He hardly ate for 2 or 3 days... he wasn't hungry (are you when you are ill ?) They do have enough reserve and when they are ill they don't use as many calories anyway... so I wouldn't worry about his food intake (unless this was going on for many days).
He really needs to rest and have no stress on him... just let him "be sick" - this is his body's way of dealing with his system.

On the fruit pure : Need to add that some fruits are very acidic and he won't want to eat those .... they will make it worst.

I don't think my local H & B sell Sojasun and only one health food shop does, but Sainsbury's do normally sell plain Yofu (500g size) and Morrsion's occasionally have it. I have only found Sojasun at a proper wholefood shop and now buy it from the wholesalers myself.

I have a relative to whom this happens ever time he eats tomatos. Could this be an allergy? Also agree that acidic foods will make it worse.

I don't know but I always know when my son has ulcers because he will refuse a tomato (without trying it).... when he is unwell !

thanks pupuce, in fact I think your message is very helpful, I think sometimes you need to let your body deal with things and build up its immunity, and maybe I should have mentioned before (but the doctor said that it wasnt a direct effect) that he a couple of weeks ago had his Measles vaccine, so I wasnt sure if it was his immune system dealing the live vaccine and as you mentioned he could be run down, and his back teeth r coming through too - it may even be a combination of the two.

I just thought with him not getting any nutrients with his food or drink and not sleeping how was he going to be fit enough to get rid of them, it would be different if he had a good nights sleep with the cream on, but screaming all day/night cant be doing that much good to his throat which is already sore.. I have some baby multi vitamin drops to put into one of his drinks to help him out a little.

Jelly went down nicely this lunchtime

he doesnt really eat tomatos, he went through a stage about two months ago eating the cherry tomatos but now just sticks his fingers in the juicy bit and says 'martos.... sticky'...

Alley22 - agree with all postings here - get him checked for the herpes virus - and go back as an 'emergency' to GP - it is an emergency for the poor lad.
A word of warning also - bonjela is ok short term, but long term use actually aggravates the ulcers and makes them worse - as a long term ulcer sufferer, found this out to my cost after a particularly bad dose (it does warn you of this side effect on the info leaflet). My GP gave me a steroid spray (not at all stingy), which helped a lot but this may well not be suitable for a 22 mth old. I've always got them worse when I'm run down - I've also discovered zinc supplements have helped me personally - but again, not necessarily recommended in a 22 month old! I guess you could ask your GP or pharmacist - oh, and cleaning my teeth always helps too - found the relief is almost as good as using bonjela etc. Have you tried anbesol liquid in the short term? Much easier to apply than bonjela, as it doesn't slide around, and can be used on babies - unlike bonjela, no side effects with longer term use

totally agree with pupuce. Good luck - i really hope it starts to settle down soon. It also sounds to me like it could be thrush.

Does sound very like herpes simplex virus, the same one that causes cold sores in later life.
The initial infection with HSV1 as it is called (HSV2 produces genital herpes)is just as you describe, often affecting very young children, and can affect any part of the mouth and throat producing a condition called primary herpetic gingivostomatitis.( you could try puting that in a search engine - you might even get some pictures). The mouth signs are usually accompanied by fever and general malaise.
It is thought to be acquired when an adult with a cold sore kisses the child.
If it affects the gingivae right next to the teeth you get a quite spectacular appearance as the gums swell up and the teeth appear to almost disappear.
The intial appearance is of lots of small blisters (vesicles) which rupture leaving ulcers which sometimes join up to form great raw areas. Sometimes the vesicles are not noticed at all.
The tongue may acquire a coated appearance, thought to be due to dehydration.
The most dangerous aspect of the condition is the risk of dehydration - wee kids can become dehydrated very quickly so let him drink plenty of fluids and he might enjoy ice lollies too.
Serious complications can occur (encephalitis) but are very rare.
Treatment is symptomatic, ie simple pain killers (calpol) , plenty of fluids as mentioned and in severe cases an anti viral drug can be given (aciclovir)but this is rarely used in kids .
Your doctor or dentist can prescribe a benzydamine hydrochloride anaesthetic mouthwash or spray if you can help your wee boy to use it properly - it's not meant for young kids but many quite young kids are surprisingly able to follow instructions to rinse and spit.However it sounds like your little guy might not go along with this!
Have to agree with whoever said bonjella was useless and actually prolongs the problem.
It can take about 10-14 days to resolve completely and your son will always have the virus lying dormant. if it gets reactivated in later life ( stress, sunlight, alcohol,low immunity ) it will be in the form of a cold sore. This does not however mean he will definately be prone to cold sores and there is some evidence that if a child gets primary herpetic gingivostomatitis any later HSV1 manifestations will be mild.
The take home message from all of this is FLUIDS!
Hope he is feeling better soon.

Should add, mild cases are often misdiagnosed as teething.