Most doctors rely on a battery of tests to diagnose a disease
A healthy tongue is pink in colour and covered with small nodules. It is neither too thick nor too thin. (Representational image)
Hyderabad: The strongest muscle in the body, the tongue, is also a good indicator of underlying diseases. It is considered to be one of the highly critical aspects of clinical examination. Hence to ensure that it can be put to best use, a group of young engineering students of Chennai have developed a digital analysis system to photograph the tongue.
This device is being set up for patients who have difficulty travelling to towns or cities to meet doctors. Hence for a quick analysis, this system is being developed for the places where basic medical care is out of reach.
Symptoms like extreme, ongoing dryness of the tongue are indicators of immunological disorders and also dehydration, kidney disorders and Crohn’s disease.
Re-emphasize the age-old concept:
In the old days, doctors always asked patients to stick out their tongue. Is this method still practised regularly? Not so often. Reason being there are a battery of tests available on which most rely upon. But there are a sizeable number of doctors who feel that there is a need to re-emphasize on this concept as part of their daily practice. While it is taught to medical students and most of them are aware of it, the practice is followed only when certain diseases are suspected.
Dr J. Sreekanth, senior consultant physician at Apollo Hospitals, says, “When the protocol of examinations is followed by a doctor then the need for a battery of tests is reduced. It’s not that the tests are not required, they will be but it (examining the tongue) serves as a pointer and is cost-effective. But it must be noted that only an examination can’t assess the severity of the disease. For this relevant tests are needed.”
Often, doctors wrap the tip of the tongue in a piece of gauze so that they can lift with ease and view underneath as well as the sides. This examination is found to help clinicians to assess the structure, thickness, vascularity, the colour and the movement of the entire tongue. Through this diseases like Macroglossia (secondary to tumour of the pituitary) can be picked up.
Dr Sreekanth adds, “A pale tongue gives an important indication of a common condition like nutritional anaemia. By checking the movement of the tongue, the neurological integrity can be ascertained, which is a sign of brain stroke. Pigmentation of the tongue can be seen in various nutritional deficiencies, smoking, tobacco chewing etc.
What does discolouration of tongue mean?
Pale tongue indicates anaemia
Yellow tongue indicates jaundice
Bluish tongue indicates cyanosis (a low oxygen supply state)
Purple tongue indicates vitamin (Riboflavin) deficiency
Strawberry tongue is seen in some diseases like scarlet fever, Kawasaki disease and others
Whitish curdy patches over tongue, a fungal infection, may indicate underlying immune compromised state such as HIV infection
Whitish lacy lesions may indicate premalignant stages
What does dry tongue indicate?
It indicates dehydration. Doctors ask for history of vomiting, diarrhea, strenuous work, exposure to heat etc. If the person is dehydrated, timely rehydration is essential and is life saving.
What does texture of the tongue signify?
Smooth and bald tongue indicates vitamin deficiency such as B12, Riboflavin and sometimes minerals (iron) deficiency.
Geographical tongue, tongue that has discolored painless “map like” patches, is a benign condition prevalent in the general population.
Hairy tongue is seen in viral infections (Ebstein Barr virus)
Black hairy tongue indicates a prolonged use of penicillin, and fungal infection.
Furrowing of the tongue may be benign or associated with syphilis infection.
When a chronic ulcer persists for a long time over the tongue, in a patient who smokes or chews tobacco, it may be an indicator of cancer.
What does engorgement of the tongue mean?
It is due to drug allergy, food allergy or vasamol poisoning
Enlargement of the tongue is seen in hypothyroidism due to excess of growth hormone
When the tongue is very thin, it is an indicator of vitamin deficiency
A swollen tongue indicates spleen deficiency
Curled tongue is an indication of liver problems
Deep cracks in the tongue indicate heart imbalance
Not a specific diagnosis:
Tongue diagnosis alone is not considered a perfect picture of a disorder. It must be looked at as a writing on the wall and take effective steps to control the disorder. Dr Sashikant Jonnalagadda, head and neck oncology consultant at Citizens Hospital explains, “The tongue helps us point to the right direction of diagnosis. But there are many tests, which are required to be done to arrive at the exact diagnosis. It is an indicator but can’t be termed as accurate all the time.”
There are times when certain diseases do not manifest in the tongue. Dr Sashikant adds, “Some signs and symptoms are very similar to other diseases. Like continuous mouth ulcers in some cases are also due to allergic reactions to certain foods. While in those who eat gutka and smoke, it is due to the heat generated in the body and is also an indicator of cancer. Appearance of the tongue in most cases is neither specific nor sensitive to the disease. Due to this, it can’t be solely relied upon for a specific diagnosis.”
( Source : deccan chronicle )
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