Tientallen tips tegen aften.

Beste Meneer van Quickenborne,

Wat een geweldige lijst met tips over aften heeft u op uw site staan. Hartelijk dank daarvoor.
Ik (Marieke, 29 jaar oud) heb al jaren last van aften. Er is echt geen pijl op te trekken wanneer, hoe en waarom de aften in mijn mond verschijnen en hoe ze weer weggaan.
In de loop der tijd heb ik vanalles geprobeerd, maar ik heb geen enkel verband kunnen vinden wat een logische verklaring of remedie opleverde tegen mijn aften.
Uw tips vullen elkaar vaak aan of spreken elkaar een beetje tegen. Zo staan er veel tips over voeding, maar als ik die allemaal tegelijk opvolg weet ik nog niet wat nou precies helpt en wat niet.
Heeft u misschien een tip over hoe ik stapsgewijs kan onderzoeken wat de oorzaak en (hopelijk) oplossing van mijn aften kan zijn?

Ik hoop van u te horen!

Heel veel dank en groeten van Marieke van Veen

Beste Meneer van Quickenborne,

Wat een geweldige lijst met tips over aften heeft u op uw site staan. Hartelijk dank daarvoor.
Ik (Marieke, 29 jaar oud) heb al jaren last van aften. Er is echt geen pijl op te trekken wanneer, hoe en waarom de aften in mijn mond verschijnen en hoe ze weer weggaan.
In de loop der tijd heb ik vanalles geprobeerd, maar ik heb geen enkel verband kunnen vinden wat een logische verklaring of remedie opleverde tegen mijn aften.
Uw tips vullen elkaar vaak aan of spreken elkaar een beetje tegen. Zo staan er veel tips over voeding, maar als ik die allemaal tegelijk opvolg weet ik nog niet wat nou precies helpt en wat niet.
Heeft u misschien een tip over hoe ik stapsgewijs kan onderzoeken wat de oorzaak en (hopelijk) oplossing van mijn aften kan zijn?

Ik hoop van u te horen!

Heel veel dank en groeten van Marieke van Veen

Hebt u al wat van die middeltjes kunnen testen? Ik word ook al jaren geplaagd door aften en heb jammer genoeg nog geen enkel doeltreffend middel gevonden.

Hebt u al wat van die middeltjes kunnen testen? Ik word ook al jaren geplaagd door aften en heb jammer genoeg nog geen enkel doeltreffend middel gevonden.

Nog een “middel” tegen aftjes.. MAAR een dat WEL werkt (80% van de lijst werkt niet bij grote hardnekkige aften): “Oralmedics”, verkrijgbaar bij de apotheek (wel niet goedkoop, +- 9 euro voor 3 “beurten” ) …

opgepast wel: NIET VOOR MIETJES … je springt letterlijk en figuurlijk tegen het plafond, want het is EXTREEM “piekend”… maar het is wel het beste dat ik tot hiertoe heb gehad SAMEN met Afta Juventus (zie lijst) …

Groetjes,
Jasper
ps: jammer dat Afta Juventus hier niet verkrijgbaar is, daarom maar Oralmedics proberen, maar zoals ik al zei.. het doet VERSCHRIKKELIJK pijn de eerste 5 seconden

Nog een “middel” tegen aftjes.. MAAR een dat WEL werkt (80% van de lijst werkt niet bij grote hardnekkige aften): “Oralmedics”, verkrijgbaar bij de apotheek (wel niet goedkoop, +- 9 euro voor 3 “beurten” ) …

opgepast wel: NIET VOOR MIETJES … je springt letterlijk en figuurlijk tegen het plafond, want het is EXTREEM “piekend”… maar het is wel het beste dat ik tot hiertoe heb gehad SAMEN met Afta Juventus (zie lijst) …

Groetjes,
Jasper
ps: jammer dat Afta Juventus hier niet verkrijgbaar is, daarom maar Oralmedics proberen, maar zoals ik al zei.. het doet VERSCHRIKKELIJK pijn de eerste 5 seconden

Schrap Zendium maar van ‘t lijstje…

De werking tegen aften van deze tandpasta heeft zelfs Wikipedia gehaald, maar in Belgie is hij niet meer te vinden…
Iemand bij Sara Lee of Unilever (volgens bronnen op het internet zou Unilever Zenium overgenomen hebben van Sara Lee) vond blijkbaar dat ze al hun trouwe klanten (zelf al meer dan 20 jaar) zonder boe of ba in de kou kunnen laten staan.

Ik ga er in Nederland moeten gaan halen…

Groeten,

Steven

Schrap Zendium maar van ‘t lijstje…

De werking tegen aften van deze tandpasta heeft zelfs Wikipedia gehaald, maar in Belgie is hij niet meer te vinden…
Iemand bij Sara Lee of Unilever (volgens bronnen op het internet zou Unilever Zenium overgenomen hebben van Sara Lee) vond blijkbaar dat ze al hun trouwe klanten (zelf al meer dan 20 jaar) zonder boe of ba in de kou kunnen laten staan.

Ik ga er in Nederland moeten gaan halen…

Groeten,

Steven

Hier de verklaring van de oorzaak van aften en de toepassing van DAPSONE

Voordracht van Prof Dr Luc DE CLERCK
28 mei 2002

Behcet is een zeldzame ziekte: de prevalentie is 1 op 100.000 inwoners in onze landen. Ze is wel meer frequent rond de Middellandse Zee. In de dienst Reumatologie van het Universitair Ziekenhuis zien we de ziekte meer bij mensen uit die landen.

Behcet is een ziekte met antistoffen en ontstekingen zoals dat bijvoorbeeld ook het geval is bij reumatoïde artritis.

Er zijn wel meer mensen die regelmatig aften hebben maar slechts bij een beperkt deel van hen is dat te wijten aan Behcet.

Die ziekte komt meest voor bij jonge mannen, bij wie ze dan begint tussen 20 en 30 jaar.

OORZAAK

De oorzaak bestaat uit verschillende factoren.

Witte bloedcellen

In het immuun systeem keert een deel van de witte bloedcellen zich tegen structuren van het eigen lichaam. De start wordt hier gegeven door de B-cellen die de antistoffen aanmaken en de Th-cellen die de B-cellen daartoe aanzetten. Een zeer belangrijke rol wordt gespeeld door de cellen die men vindt op de plaats van de ontstekingen: neutrofielen en lymfocyten ttz B-cellen en T-cellen.

Antigeen

De B-cellen en T-cellen vermenigvuldigen zich na contact met een of ander antigeen. Dat is niet bij elke patiënt hetzelfde en men kent ze niet alle. Men vindt het antigeen ook niet altijd. Dat kan bijvoorbeeld het herpes virus zijn dat iedereen kent omdat het de koortsblaasjes op de lippen geeft. Heel veel mensen hebben koortsblaasjes en heel weinig mensen hebben Behcet: er is dus veel meer nodig dan het herpes virus om Behcet te veroorzaken. Het kunnen ook streptokokken zijn van het type dat luchtwegen infecties veroorzaakt.
Bacteriën zijn dragers van een reeks superantigenen, waaronder de heat shock proteins, waartegen het immuun systeem bij voorkeur antistoffen aanmaakt. Heat shock proteins ( HSP = stress eiwitten) zijn aanwezig in de mitochondriën van alle cellen, in grotere hoeveelheden bij koorts, koude en zuurstoftekort. Bij erge gebreken in de cel komen ze aan de oppervlakte op het membraan van de cel. Structuren gelijkend op deze superantigenen van de bacteriën, vindt men dus ook in het lichaam van de mens, bijvoorbeeld in het netvlies van het oog. Het immuun systeem dat eerst de bacteriën opgeruimd heeft, valt daarna ook de gelijkende structuren in eigen lichaam aan. In het bloed van Behcet patiënten vindt men antistoffen tegen een van deze heat shock proteïnen van de streptokokken. Deze antistoffen blijken ook gericht te zijn tegen het gelijkend eiwit in het netvlies van het oog. Spuit men die eiwitten of de antistoffen in bij proefdieren dan krijgen deze ontstekingen zoals deze die men vindt bij Behcet.
Men vindt ook T-cellen tegen het Retinal S-antigeen, dat een rol speelt bij verschillende oog ontstekingen. Ontstekingen van het oog zijn dan ook een van de belangrijkste en gevaarlijkste bij Behcet.

Genetische voorbeschikking

Er is in de HLA bloedgroepen een belangrijke voorbeschikking voor Beh-cet. Dat is zo voor de meeste auto immuun ziekten: Bechterew is geassocieerd met HLA B –27… Voor Behcet is dat de bloedgroep HLA B-51. Dat betekent dat mensen die HLA B-51 hebben, meer kans lopen om na een bepaalde infectie Behcet te krijgen. Veel mensen hebben die bloedgroep, maar slechts zeer weinigen hebben Behcet. Hier ook weer is er veel meer nodig dan een HLA B-51 om Behcet te veroorzaken.

Hormonen

Daar vooral mannen de ziekte krijgen, veronderstelt men dat hormonen een rol spelen, namelijk dat vrouwelijke hormonen (oestrogeen…) de escalatie van het ziekteproces ergens afremmen.

Thymus

Het is de thymus (zwezerik) die in de kinderjaren de T-cel afdeling (= thymus cellen) van de witte bloedcellen opbouwt. Alle T-cellen die tegen geen enkele structuur van het eigen lichaam gericht zijn, en die dus alleen vreemde deeltjes kunnen vernietigen, worden daarin tot rijping gebracht. Degenen die schade aan het eigen lichaam zouden kunnen berokkenen, worden geëlimineerd. Dat is de T-cel selectie in de thymus. Auto immuun ziekten worden gestart doordat bij infectie met bijvoorbeeld een bacterie, een Th-cel vermenigvuldigd wordt die tegen een eigen lichaamsstructuur gericht is. Dat is tegen de regels van de selectie. Dat gebeurt echter bij heel veel mensen in beperkte mate zonder dat zij daarvan een auto immuun ziekte krijgen. Er is dus ook hier meer nodig om de ziekte op gang te brengen.

Een studie waarin gepubliceerd wordt dat thymectomie in een aantal gevallen Behcet verbetert, doet vermoeden dat het aanwakkeren van de T-cellen bij Behcet deels in de thymus zelf gebeurt.

HYPOTHESE

De bacterie komt binnen langs de mond of de keel en veroorzaakt daar een infectie. Door analogie van de structuren op het membraan van de bacterie met de structuren in het lichaam worden de Th-cellen, die de bacterie geëlimineerd hebben, misleid en aangewakkerd in de thymus zodat ze ook de gelijkende structuren aanvallen en doen ontsteken in het eigen lichaam: in het oog, de mond…

MEER GEDETAILLEERDE HYPOTHESE

Een bepaalde trigger, bijvoorbeeld de infectueuze streptokokken die bepaalde heat shock proteins (HSP 65) dragen, start het immuun antwoord door het activeren van de Th-cel. Dat evolueert bij personen met HLA B-51 tot een ontsteking tegen gelijkende eiwitten van eigen organen. In een ontstekingscascade worden T-lymfocyten en neutrofielen geactiveerd, die het immuun antwoord in de ontsteking versterken. De talrijke aanwezigheid van neutrofielen in de ontstekingen wordt toegeschreven aan een verhoogde beweeglijkheid (chemotaxis) van de neutrofielen. Zo ontstaat chronische ontsteking van het oog (uveitis), vooral van de binnenzijde van de voorste oogkamer (anterior uveitis) met het regenboogvlies (iritis) en minder van de achterste oogkamer (posterior uveitis) waarbij het netvlies (retinitis) aangetast wordt. De chronic posterior uveitis kan blindheid veroorzaken en is een van de ernstigste problemen van Behcet.

KLINISCHE DIAGNOSE

Er zijn meerdere sets van regels voor de diagnose, waarvan er hier twee vermeld zijn.

De eerste dateert van 1969. Ze geeft de criteria voor Behcet:

1. Behcet is altijd gekenmerkt door steeds terugkerende (recidiverende), ernstige en pijnlijke aften. Iedereen heeft al eens aften, maar alleen bij mensen die 3 tot 4 keer per jaar episodes doen van grotere aften vooral in de mond moet men denken aan Behcet. Die aften zijn pijnlijk maar geven verder geen invalidering. Vaak zijn er ook aften aan de genitaliën.

2. Oog ontstekingen komen veelvuldig voor en die geven wel invalidering die daarenboven blijvend is en die in ernstige gevallen tot blindheid kan leiden.

3. Op de huid zijn er dikwijls pijnlijke letsels als puisten, knobbels, ulceraties…

Verder is er een heel scala verschijnselen die bij een min of meer groot aantal patiënten voorkomen:

- ontstekingen van het maag-darm stelsel met afwijkingen zoals aften, ziekte van Crohn en colitis ulcerosa

- tromboflebitis waarbij verstoppingen in de aders (venen) optreden

- arteritis of ontstekingen van de slagaders, wat wel ernstiger is

- hartaantasting ttz hartvliesontsteking en ontsteking van de coronairen (hartslagaders), wat minder frequent is

- aantasting van het centraal zenuwstelsel met een soort meningitis, relatief frequent, en met eventueel ook tijdelijke verlamming door ontsteking van zenuwbanen, wat minder frequent is

- gewrichtsontsteking die meestal een niet invaliderende artritis is.

Reumatoïde artritis geeft blijvende beschadiging van het kraakbeen. De gewrichtsontstekingen bij Behcet geven vochtophoping en veel pijn maar geen definitieve beschadiging van het kraakbeen.
Als men de ziekte onder controle krijgt, houdt de patiënt daarvan geen blijvende schade over aan de gewrichten. Die is er wel aan de ogen en dat is het grootste probleem bij ernstige Behcet.

De diagnose van Behcet is niet eenvoudig: er is geen diagnostisch criterium of gouden standaard. Een 12-tal jaar geleden werden in de Lancet, het meest toonaangevend Medisch Wetenschappelijk Tijdschrift, regels voor de diagnose van Behcet gepubliceerd. Deze zijn een meer recente update van de voorgaande.

De aften in de mond zien eruit zoals de klassieke aften, niet kleiner en ook niet groter, en zijn pijnlijk en veel talrijker en frequenter bij Behcet patiënten dan bij anderen. Ze recidiveren en gaan samen met een reeks andere suggestieve ontstekingen zoals: ontstekingen aan maag en darmen, aders en hart, zenuwstelsel en gewrichten.

In de families met bloedgroep HLA B-51 komt Behcet meer frequent voor. De pathergie test is vrij specifiek voor Behcet. Als het resultaat positief is dan is er Behcet. Maar ze is slechts positief bij 1 op 4 patiënten: is het resultaat negatief dan kan er toch Behcet zijn.
Als men een bloedstaaltje neemt en er ontwikkelt zich op die plaats een pusteltje dat eruit ziet als een klein zweertje dan bevestigt dat de diagnose van Behcet. Bij het vermoeden van Behcet prikte men vroeger met een naald in de huid en controleerde 24-48 uur daarna of er een specifiek etter- pusteltje was. Dat wordt veroorzaakt doordat er in de ontstekingen bij Behcet een accumulatie is van witte bloedcellen, hoofdzakelijk neutrofielen.

Bij de diagnose van Behcet zal men er opletten dat aften in de mond en een aantal van de ontstekingen in verschillende organen ook kunnen voorkomen bij andere ziekten als:
- auto immuun ziekten: lupus, reumatoïde artritis… ziekte van Crohn…
- ziekten verwekt door medicamenten: Stevens-Johnson…
- infecties: herpes…
Het is het steeds weerkeren van de aften samen met het aanwezig zijn van de associatie van bepaalde ontstekingen die tot de diagnose van Behcet leidt.

LABORATORIUM PROEVEN

De diagnose van Behcet is vooral een klinische diagnose. Er is nog geen laboratorium test die ons een gouden standaard geeft zoals de ANF-test voor lupus of de reuma factor voor reumatoïde artritis.

De pathergie test is wel specifiek voor Behcet maar niet gevoelig. Is ze positief dan is er Behcet maar slechts bij een minderheid van de patiënten is ze positief. Ze bevestigt de verhoogde beweeglijkheid (chemotaxis) van de neutrofielen.

Verder kan men in het laboratorium verschillende elementen meten die niet specifiek zijn omdat ze ook bij veel andere ziekten voorkomen.
In het bloed zijn de bezinkingen van de rode bloedcellen verhoogd en kan men de immuun complexen aantonen.
Bij een aantal patiënten vindt men met verfijnde technieken de antistoffen tegen slijmvliezen, bloedvat-endotheel, bepaalde membraan eiwitten zoals cardiolipine…

Toch worden er bij de diagnose van Behcet bloedtesten gedaan omdat die vereist zijn voor het uitsluiten van verschillende van de ziekten met ontstekingen gelijkend op die van Behcet. Ook later zijn bloedtesten soms nodig om het goede effect of de bijwerkingen van een medicatie te volgen.

In het laboratorium is men op dit ogenblik nog volop bezig met de opheldering van het ziekteproces en eerst daarna zal men criteria voor de diagnose kunnen geven.

ZIEKTEBEELDEN

Aften

Aften bij Behcet kunnen alle afmetingen hebben van enkele millimeter tot centimeters en hun aantal kan variëren. Ze hebben hetzelfde voorkomen als de klassieke aften maar zijn talrijker en komen regelmatig terug. Ze kunnen zich bevinden op de lippen, op het verhemelte en in de keel, evenals aan de genitaliën. Op het scrotum kunnen ze ook bloeden.
De aften aan de genitaliën kunnen zeer pijnlijk zijn maar zijn zeldzamer en komen minder dikwijls terug dan de aften in de mond.

Hier de verklaring van de oorzaak van aften en de toepassing van DAPSONE

Voordracht van Prof Dr Luc DE CLERCK
28 mei 2002

Behcet is een zeldzame ziekte: de prevalentie is 1 op 100.000 inwoners in onze landen. Ze is wel meer frequent rond de Middellandse Zee. In de dienst Reumatologie van het Universitair Ziekenhuis zien we de ziekte meer bij mensen uit die landen.

Behcet is een ziekte met antistoffen en ontstekingen zoals dat bijvoorbeeld ook het geval is bij reumatoïde artritis.

Er zijn wel meer mensen die regelmatig aften hebben maar slechts bij een beperkt deel van hen is dat te wijten aan Behcet.

Die ziekte komt meest voor bij jonge mannen, bij wie ze dan begint tussen 20 en 30 jaar.

OORZAAK

De oorzaak bestaat uit verschillende factoren.

Witte bloedcellen

In het immuun systeem keert een deel van de witte bloedcellen zich tegen structuren van het eigen lichaam. De start wordt hier gegeven door de B-cellen die de antistoffen aanmaken en de Th-cellen die de B-cellen daartoe aanzetten. Een zeer belangrijke rol wordt gespeeld door de cellen die men vindt op de plaats van de ontstekingen: neutrofielen en lymfocyten ttz B-cellen en T-cellen.

Antigeen

De B-cellen en T-cellen vermenigvuldigen zich na contact met een of ander antigeen. Dat is niet bij elke patiënt hetzelfde en men kent ze niet alle. Men vindt het antigeen ook niet altijd. Dat kan bijvoorbeeld het herpes virus zijn dat iedereen kent omdat het de koortsblaasjes op de lippen geeft. Heel veel mensen hebben koortsblaasjes en heel weinig mensen hebben Behcet: er is dus veel meer nodig dan het herpes virus om Behcet te veroorzaken. Het kunnen ook streptokokken zijn van het type dat luchtwegen infecties veroorzaakt.
Bacteriën zijn dragers van een reeks superantigenen, waaronder de heat shock proteins, waartegen het immuun systeem bij voorkeur antistoffen aanmaakt. Heat shock proteins ( HSP = stress eiwitten) zijn aanwezig in de mitochondriën van alle cellen, in grotere hoeveelheden bij koorts, koude en zuurstoftekort. Bij erge gebreken in de cel komen ze aan de oppervlakte op het membraan van de cel. Structuren gelijkend op deze superantigenen van de bacteriën, vindt men dus ook in het lichaam van de mens, bijvoorbeeld in het netvlies van het oog. Het immuun systeem dat eerst de bacteriën opgeruimd heeft, valt daarna ook de gelijkende structuren in eigen lichaam aan. In het bloed van Behcet patiënten vindt men antistoffen tegen een van deze heat shock proteïnen van de streptokokken. Deze antistoffen blijken ook gericht te zijn tegen het gelijkend eiwit in het netvlies van het oog. Spuit men die eiwitten of de antistoffen in bij proefdieren dan krijgen deze ontstekingen zoals deze die men vindt bij Behcet.
Men vindt ook T-cellen tegen het Retinal S-antigeen, dat een rol speelt bij verschillende oog ontstekingen. Ontstekingen van het oog zijn dan ook een van de belangrijkste en gevaarlijkste bij Behcet.

Genetische voorbeschikking

Er is in de HLA bloedgroepen een belangrijke voorbeschikking voor Beh-cet. Dat is zo voor de meeste auto immuun ziekten: Bechterew is geassocieerd met HLA B –27… Voor Behcet is dat de bloedgroep HLA B-51. Dat betekent dat mensen die HLA B-51 hebben, meer kans lopen om na een bepaalde infectie Behcet te krijgen. Veel mensen hebben die bloedgroep, maar slechts zeer weinigen hebben Behcet. Hier ook weer is er veel meer nodig dan een HLA B-51 om Behcet te veroorzaken.

Hormonen

Daar vooral mannen de ziekte krijgen, veronderstelt men dat hormonen een rol spelen, namelijk dat vrouwelijke hormonen (oestrogeen…) de escalatie van het ziekteproces ergens afremmen.

Thymus

Het is de thymus (zwezerik) die in de kinderjaren de T-cel afdeling (= thymus cellen) van de witte bloedcellen opbouwt. Alle T-cellen die tegen geen enkele structuur van het eigen lichaam gericht zijn, en die dus alleen vreemde deeltjes kunnen vernietigen, worden daarin tot rijping gebracht. Degenen die schade aan het eigen lichaam zouden kunnen berokkenen, worden geëlimineerd. Dat is de T-cel selectie in de thymus. Auto immuun ziekten worden gestart doordat bij infectie met bijvoorbeeld een bacterie, een Th-cel vermenigvuldigd wordt die tegen een eigen lichaamsstructuur gericht is. Dat is tegen de regels van de selectie. Dat gebeurt echter bij heel veel mensen in beperkte mate zonder dat zij daarvan een auto immuun ziekte krijgen. Er is dus ook hier meer nodig om de ziekte op gang te brengen.

Een studie waarin gepubliceerd wordt dat thymectomie in een aantal gevallen Behcet verbetert, doet vermoeden dat het aanwakkeren van de T-cellen bij Behcet deels in de thymus zelf gebeurt.

HYPOTHESE

De bacterie komt binnen langs de mond of de keel en veroorzaakt daar een infectie. Door analogie van de structuren op het membraan van de bacterie met de structuren in het lichaam worden de Th-cellen, die de bacterie geëlimineerd hebben, misleid en aangewakkerd in de thymus zodat ze ook de gelijkende structuren aanvallen en doen ontsteken in het eigen lichaam: in het oog, de mond…

MEER GEDETAILLEERDE HYPOTHESE

Een bepaalde trigger, bijvoorbeeld de infectueuze streptokokken die bepaalde heat shock proteins (HSP 65) dragen, start het immuun antwoord door het activeren van de Th-cel. Dat evolueert bij personen met HLA B-51 tot een ontsteking tegen gelijkende eiwitten van eigen organen. In een ontstekingscascade worden T-lymfocyten en neutrofielen geactiveerd, die het immuun antwoord in de ontsteking versterken. De talrijke aanwezigheid van neutrofielen in de ontstekingen wordt toegeschreven aan een verhoogde beweeglijkheid (chemotaxis) van de neutrofielen. Zo ontstaat chronische ontsteking van het oog (uveitis), vooral van de binnenzijde van de voorste oogkamer (anterior uveitis) met het regenboogvlies (iritis) en minder van de achterste oogkamer (posterior uveitis) waarbij het netvlies (retinitis) aangetast wordt. De chronic posterior uveitis kan blindheid veroorzaken en is een van de ernstigste problemen van Behcet.

KLINISCHE DIAGNOSE

Er zijn meerdere sets van regels voor de diagnose, waarvan er hier twee vermeld zijn.

De eerste dateert van 1969. Ze geeft de criteria voor Behcet:

1. Behcet is altijd gekenmerkt door steeds terugkerende (recidiverende), ernstige en pijnlijke aften. Iedereen heeft al eens aften, maar alleen bij mensen die 3 tot 4 keer per jaar episodes doen van grotere aften vooral in de mond moet men denken aan Behcet. Die aften zijn pijnlijk maar geven verder geen invalidering. Vaak zijn er ook aften aan de genitaliën.

2. Oog ontstekingen komen veelvuldig voor en die geven wel invalidering die daarenboven blijvend is en die in ernstige gevallen tot blindheid kan leiden.

3. Op de huid zijn er dikwijls pijnlijke letsels als puisten, knobbels, ulceraties…

Verder is er een heel scala verschijnselen die bij een min of meer groot aantal patiënten voorkomen:

- ontstekingen van het maag-darm stelsel met afwijkingen zoals aften, ziekte van Crohn en colitis ulcerosa

- tromboflebitis waarbij verstoppingen in de aders (venen) optreden

- arteritis of ontstekingen van de slagaders, wat wel ernstiger is

- hartaantasting ttz hartvliesontsteking en ontsteking van de coronairen (hartslagaders), wat minder frequent is

- aantasting van het centraal zenuwstelsel met een soort meningitis, relatief frequent, en met eventueel ook tijdelijke verlamming door ontsteking van zenuwbanen, wat minder frequent is

- gewrichtsontsteking die meestal een niet invaliderende artritis is.

Reumatoïde artritis geeft blijvende beschadiging van het kraakbeen. De gewrichtsontstekingen bij Behcet geven vochtophoping en veel pijn maar geen definitieve beschadiging van het kraakbeen.
Als men de ziekte onder controle krijgt, houdt de patiënt daarvan geen blijvende schade over aan de gewrichten. Die is er wel aan de ogen en dat is het grootste probleem bij ernstige Behcet.

De diagnose van Behcet is niet eenvoudig: er is geen diagnostisch criterium of gouden standaard. Een 12-tal jaar geleden werden in de Lancet, het meest toonaangevend Medisch Wetenschappelijk Tijdschrift, regels voor de diagnose van Behcet gepubliceerd. Deze zijn een meer recente update van de voorgaande.

De aften in de mond zien eruit zoals de klassieke aften, niet kleiner en ook niet groter, en zijn pijnlijk en veel talrijker en frequenter bij Behcet patiënten dan bij anderen. Ze recidiveren en gaan samen met een reeks andere suggestieve ontstekingen zoals: ontstekingen aan maag en darmen, aders en hart, zenuwstelsel en gewrichten.

In de families met bloedgroep HLA B-51 komt Behcet meer frequent voor. De pathergie test is vrij specifiek voor Behcet. Als het resultaat positief is dan is er Behcet. Maar ze is slechts positief bij 1 op 4 patiënten: is het resultaat negatief dan kan er toch Behcet zijn.
Als men een bloedstaaltje neemt en er ontwikkelt zich op die plaats een pusteltje dat eruit ziet als een klein zweertje dan bevestigt dat de diagnose van Behcet. Bij het vermoeden van Behcet prikte men vroeger met een naald in de huid en controleerde 24-48 uur daarna of er een specifiek etter- pusteltje was. Dat wordt veroorzaakt doordat er in de ontstekingen bij Behcet een accumulatie is van witte bloedcellen, hoofdzakelijk neutrofielen.

Bij de diagnose van Behcet zal men er opletten dat aften in de mond en een aantal van de ontstekingen in verschillende organen ook kunnen voorkomen bij andere ziekten als:
- auto immuun ziekten: lupus, reumatoïde artritis… ziekte van Crohn…
- ziekten verwekt door medicamenten: Stevens-Johnson…
- infecties: herpes…
Het is het steeds weerkeren van de aften samen met het aanwezig zijn van de associatie van bepaalde ontstekingen die tot de diagnose van Behcet leidt.

LABORATORIUM PROEVEN

De diagnose van Behcet is vooral een klinische diagnose. Er is nog geen laboratorium test die ons een gouden standaard geeft zoals de ANF-test voor lupus of de reuma factor voor reumatoïde artritis.

De pathergie test is wel specifiek voor Behcet maar niet gevoelig. Is ze positief dan is er Behcet maar slechts bij een minderheid van de patiënten is ze positief. Ze bevestigt de verhoogde beweeglijkheid (chemotaxis) van de neutrofielen.

Verder kan men in het laboratorium verschillende elementen meten die niet specifiek zijn omdat ze ook bij veel andere ziekten voorkomen.
In het bloed zijn de bezinkingen van de rode bloedcellen verhoogd en kan men de immuun complexen aantonen.
Bij een aantal patiënten vindt men met verfijnde technieken de antistoffen tegen slijmvliezen, bloedvat-endotheel, bepaalde membraan eiwitten zoals cardiolipine…

Toch worden er bij de diagnose van Behcet bloedtesten gedaan omdat die vereist zijn voor het uitsluiten van verschillende van de ziekten met ontstekingen gelijkend op die van Behcet. Ook later zijn bloedtesten soms nodig om het goede effect of de bijwerkingen van een medicatie te volgen.

In het laboratorium is men op dit ogenblik nog volop bezig met de opheldering van het ziekteproces en eerst daarna zal men criteria voor de diagnose kunnen geven.

ZIEKTEBEELDEN

Aften

Aften bij Behcet kunnen alle afmetingen hebben van enkele millimeter tot centimeters en hun aantal kan variëren. Ze hebben hetzelfde voorkomen als de klassieke aften maar zijn talrijker en komen regelmatig terug. Ze kunnen zich bevinden op de lippen, op het verhemelte en in de keel, evenals aan de genitaliën. Op het scrotum kunnen ze ook bloeden.
De aften aan de genitaliën kunnen zeer pijnlijk zijn maar zijn zeldzamer en komen minder dikwijls terug dan de aften in de mond.

Lotagen gebruik is sinds een jaar, is enkel te verkrijgen bij dierenarts,
echt een wondermiddel. niets vd apotheek hielp, maar nu ben ik na het aanbrengen van lotagen achter 2 dagen verlost van de aft.

knfagizh…

knfagizh…

Hebt u ondertussen reeds een oplossing gevonden? Ikzelf sukkel al sinds mijn kindertijd met heel veel aften. Iedere maand stond mijn mond en keel gedurende een week VOL. Ik was dan echt wel ‘ziek’ want aften doen pijn, kon niet praten enz. Ik bleef dan afwezig van school of werk.
Een jaar geleden werd ik bij een vriendin uitgenodigd op een verkoop (à la tupperware) van Forever Living Products (Aloe Vera). Daar vertelde de spreker dat de tandpasta die zij verkopen verplicht wordt ingevoerd in vele ziekenhuizen. Mensen met keelkanker die bestraald moeten worden ontwikkelen ook massale aften in hun mond. Maar twee ziekenhuizen hebben elk een patiënt ontdekt die dat niet had. Wat hadden ze gemeenschappelijk? Ze poetsten met Aloe Vera tandpasta van Forever Living products. Patienten met keelkanker worden daarom voortaan verzocht om eerst enkele weken te poetsen met aloe vera. Ik doe dat nu ook een jaar, en ik heb nooit meer een aft gehad!!
Probeer het eens!

ook ik heb veel last van aften helaas dit zijn nuttige tips en ik ga het zeker uitproberen

bedankt!

groetjes leonie van de berg

Vitamine B’s helpen het beste !
Heb onlangs zo’n dikke gehad dat ik amper iets at omdat ik er altijd op beet…

Idd het piekt wel wat. Wel het aftje goed droog maken eerst.

Wat bij mij super goed geholpen heeft is geconcentreerde pepermunttinctuur.
Is vrij goedkoop en via vele apotheken te verkrijgen.
Een paar druppeltjes op een wattestokje en dan op de aft doen.
Heel gek, die tinktuur komt enorm fris over (vaak onaangenaam). Maar op de aften voel je het zo goed als niet. Na enkele keren te druppelen ben ik van grote afte afgeraakt vorig jaar

wat de dokter altijd doet is aanstippen met een zilvernitraat stokje
je kunt het bij de apotheek kopen wel di e met het houte kokertje nemen
meestal is 1x aanstippen voldoende de aft word dan wit daarna donker en de pijn is weg
en een dag erna of 2 dagen en hij is helemaal weg

ook op doktersrecept verkrijgbaar is tetracycline dat is een antibioticum spoelmiddel
het prikt verschrikkelijk op de aften maar ik was er binnen een dag al wel van af

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Hoi Vincent,

Ik las op http://www.keelkanker.org iets over dat bacterië- en virusinfecties  een verhoogd risico zijn voor de ontwikkeling van kanker.

Maar zijn aften niet een vorm van virus- of bacterie infecties? En zou dit dan ook een verhoogd risico kunnen opleveren denk je?

Ik heb zelf ook vaak last van aften :-S

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Water ,zo heet je het kan verdragen met een grote hoeveelheid azijn en dan spoelen.
De vellen komen uit je mond maar je bent er ook snel vanaf! Of een citroen persen en daarmee tegen de aften spoelen.

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