Taste disturbances

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What is it about ?

Taste is a very complex mechanism. Don’t we often say that we also eat with our noses and eyes? A dish that looks tasty immediately arouses taste sensations and makes us want to eat. Taste therefore combines the perceptions of several senses.

In the narrow sense of the term, taste is the direct sensation that a food or drink gives in the mouth. For this purpose, we have taste buds. These are small groups of cells, located on the tongue and at the back of the mouth, which allow us to detect 5 basic flavors: sweet, sour, salty, bitter and umami. .

An important condition for their proper functioning is the presence of saliva. If they are dehydrated, the tongue and mouth do not perceive any flavor. The saliva dissolves the flavoring, so to speak, and gives it to the taste bud as a gift. The papilla, in turn, is connected to nerve endings which transmit taste stimuli to the brain, where they are recognized and translated into a taste sensation.

A taste disturbance usually means a decrease in the sense of taste, less often an erroneous taste perception. In rare cases, there may also be a total loss of taste.

The cause can be found at every stage of the taste perception process: at the level of the taste buds or the mucous membranes of the mouth and throat, at the level of nerve conduction and at the level of taste centers located in the brain.

The causes that may be at the origin of taste disturbances are:

  • a decrease in the sensitivity of the taste buds, which occurs with age,
  • damage to the mucous membranes of the tongue and mouth due to e.g. dehydration, inflammation, infection (by a fungus, virus or bacteria), poor oral hygiene, smoking, radiotherapy, etc.,
  • a lack of vitamin B12,
  • certain drugs eg. chemotherapy drugs, certain drugs that lower blood pressure (antihypertensives), drugs that lower cholesterol (cholesterol lowering drugs) and certain antidepressants
  • diabetes and thyroid disorders,
  • liver and kidney disease,
  • damage to the taste center, located in the brain, due to e.g. have a stroke, tumor, or a condition such as Parkinson’s disease or Alzheimer’s disease.

How to recognize them?

You have difficulty recognizing the different flavors. You also need larger amounts of a product to determine its taste. Because of this, one of the first signs is often a propensity to season your food more, using stronger spices, to taste something. In rare cases, you don’t taste anything at all.

Having an altered taste means that you have incorrect taste perceptions. You still perceive flavors, but you no longer taste the difference between the different flavors or the flavors you perceive do not correspond to reality. Since everything tastes less tasty, sometimes you have less of an appetite.

How is the diagnosis made?

The doctor will first ask you if your sense of smell is still intact and if you have upper respiratory symptoms (eg an allergic cold or sinusitis). In many people, a taste disorder actually masks a smell disorder. The doctor will also check if you are using any medicines that may be causing your complaints. He will then carefully examine the mouth and throat (teeth, tongue, tonsils, …).

If he cannot identify a clear cause, he will refer you to a specialist (neurologist or ENT). They will be able to perform specific taste tests to see if you are still able to taste and differentiate between tastes. An examination of the nerves of the head may also be scheduled. If necessary, a CT scan of the brain will be performed.

What can you do ?

Be sure to have good oral hygiene in all cases. Brush your teeth regularly and visit the dentist regularly for a check-up. If necessary, remove the pasty layer that covers your tongue using a tongue scraper.

Sometimes you have less appetite because of the loss of taste; so make sure you eat enough. Stimulate your taste buds by seasoning your food, but don’t go overboard with sugar and salt. Drink enough so that your mucous membranes do not dry out. You can choose carbonated drinks that are preferably sweet, sour or bitter (eg bitter lemon). If you have a dry mouth, you may be able to use artificial saliva.

Talk to your doctor to find out if your medications may be involved, so that you can adjust them if necessary. Keep in mind, however, that taste disturbances can persist for a long time after stopping the offending medication.

What can your doctor do?

There is no specific treatment for taste disorders. Your doctor will primarily focus on optimizing the management of underlying conditions such as diabetes.

Want to know more?

Source

Foreign clinical practice guide ‘Taste disorders’ (2000), updated on 22.03.2017 and adapted to the Belgian context on 20.08.2019 – ebpracticenet

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