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Diagnosing the disease with the tongue. The tongue is a muscular organ involved in speech, taste, and deglutition. It serves as an easily accessible organ for evaluating a person's health and displays the body's level of hydration.

Diagnosing the disease with the tongue

Diagnosing the disease with the tongue

According to a theory, the tongue serves as a mirror for the digestive system, reflecting any abnormalities in the stomach or intestines.

In several specific disorders, the tongue undergoes certain unique alterations. For this reason, a tongue examination is crucial and can provide some diagnostic hints. When examining the tongue, all medical professionals take into account variations in its size, shape, color, moisture, coating, papillae's nature, movements, etc.

 Tongue’s appearance under some unusual circumstances:

The tongue's movements

• When the tongue protrudes, it moves toward the paralyzed side in hemiplegia or one-sided paralysis of the body.   

• Tremulus movement of the tongue is observed in conditions such as Parkinson's disease, delirium tremens, and thyrotoxicosis. Those who are anxious can also exhibit tremors.

• The tongue would become paralyzed and wasted with fibrillation in cases of progressive bulbar palsy. The tongue eventually shrivels up and lays on the floor of the mouth, useless. Speech impediment and dripping of saliva are symptoms of this illness.

• The patient may be unable to stop the protruding tongue from moving spontaneously if they have chorea, which is defined as involuntary rhythmic movements.

 

Moistness of the tongue

This indicates a little bit about the body's level of hydration. Depletion of water volume causes peripheral circulatory failure, which manifests as thirst, restlessness, weakness, nausea, vomiting, and dry, parched tongue.

The following situations can cause tongue dryness.

The following conditions include:

•  diarrhea;
•  advanced uremia;
•  hypovolemic shock;
•  heat exhaustion;
•  hyponatremia;
•  acute intestinal blockage;
•  starvation;
•  prolonged fasting.

 

Change in tongue color

• Central cyanosis: A drop in blood oxygen levels causes cyanosis, which is a bluish discoloration of the mucous membrane. Anoxia, respiratory failure, and cardiac failure all exhibit this. The tongue, lips, etc. appear pale and blue in cyanosis.

• Jaundice: A rise in bilirubin levels in the blood causes a yellowish discoloration of all mucous surfaces, including the tongue. Hepatitis, bile duct blockage, accelerated RBC breakdown, and other conditions can cause jaundice.

• Advanced uremia: This condition is characterized by a rise in blood urea and other nitrogenous waste products brought on by renal failure. The tongue turns brown at this point.

• Keto acidosis: This acidosis, which is primarily associated with diabetes mellitus, is caused by an accumulation of ketone bodies. Here, the tongue turns dark and the mouth begins to smell like ketones.

• Deficit in riboflavin: This vitamin (vitamin B2) deficit causes lips to crack and the tongue to turn magenta in color.     

• Niacin deficit: A brilliant scarlet or meaty red tongue is the result of niacin (vitamin B3) and certain other B complex vitamin deficiencies.

• Anaemia: This is the reduction in the blood's hemoglobin percentage. A pale tongue is a sign of severe anemia.

 

The coating on the tongue

• foul breath: The creation of a pasty coating, or biofilm, on the tongue, is the primary cause of foul breath. This coating harbors thousands of anaerobic bacteria, which produce offensive gasses. The back of the tongue may have a thick layer on people who complain of foul breath.

• Typhoid fever: This illness causes the tongue to become white and curl-like hair.

• Candidiasis: This fungal illness affects the body's mucous surfaces. There will be white sores on the tongue that are peeling off.

• White lesions that are peeling off will be present in hypoadrenalism and diabetes.

• Secondary syphilis: Trepenoma pallidum infection is the cause of syphilis, a sexually transmitted illness. The disease's later stage is characterized by painless mucous patches and smooth, white, glistening, opalescent plaques that are difficult to scrape off.

• Leukoplakia:  The tongue and oral cavity exhibit white keratotic patches in this condition. This ailment is precancerous.

• AIDS: Hairy leukoplakia is observed in these patients.

• Peritonitis: This condition causes the tongue to turn white. It is an inflammation of the peritonium, the inner lining of the abdominal cavity that also covers and holds the intestines in place.

• Acute illness: Some acute disorders also exhibit furring.

 

Papillae

• Taste is connected to these tiny protuberances on the tongue. The healthy tongue has papillae of several types. These are some of the aberrant alterations that occur in some disorders.

• Hairy tongue: This disorder is brought on by the extension of the filiform papillae, which is linked to indigestion, overall weakness, and poor oral hygiene.

• Geographic tongue: The tongue exhibits erratic red and white spots in this location. These lesions resemble a map of a place. The precise reason is unknown.

• Median rhomboid glossitis: This condition is characterized by a smooth, nodular red patch in the tongue's posterior midline. This is an inherited disorder.

• Nutritional deficiency: This condition causes glossitis, or inflammation of the tongue, which in turn causes atrophy and papillary enlargement.    

• Benign migratory glossitis: This is a tongue inflammatory disorder characterized by several annular patches of papillae desquamation that emerge on the tongue and move from one area to another over a few days.

• Insufficiency in thiamine and riboflavin: This vitamin insufficiency results in hypertrophied filiform and fungiform papillae.

•  Iron and niacin deficiency: This disorder causes papillae atrophy. When iron deficient, a smooth tongue is experienced.

• Vitamin A deficiency: This results in a mouth that is pursed.

• The tongue becomes smooth in cases of nutritional megaloblastic anemia.

• Folic acid deficiency: This condition manifests as glossitis and macrocytic megaloblastic anemia.

• Cyanocobalamin deficiency: This condition causes peripheral neuropathy, glossitis, and macrocytic megaloblastic anemia.   

• Scarlet fever: a streptococcal infection characterized by brilliant red papillae poking out of thick white fur. The papillae become bigger on the bright red surface and are referred to as strawberry tongue when the white coat eventually disappears. 

 

Tongue ulcers

• Aphthous ulcers: These are circular, painful ulcers that commonly develop in people who are under stress. Possibly connected to dietary allergies. Oral mucosa, tongue, lips, and so forth are typical locations.

• Herpes simplex: The herpes simplex virus causes acute vesicular eruptions. Ulcers arise from the rupture of these vesicles.

• Cancerous ulcer: Cancerous ulcers have firm bases and everted margins. There is also bleeding. Tobacco chewers are frequently diagnosed with tongue cancer.

• Syphilitic ulcers: The longitudinal orientation of syphilitic fissures is observed. Extra genital chancre is visible on the tongue in cases of primary syphilis. Multiple shallow sores on the tongue's sides and underside are observed in secondary syphilis. Gumma can be observed on the midline of the tongue's dorsum in cases of tertiary syphilis.

• Dental ulcers: Sharp edges of carious material cause these ulcers.