Sinseh says

What's causing my mouth ulcers?

Traditional Chinese medicine practitioner at YS Healthcare
TCM Clinic at The Adelphi

Q: I am a 36-year-old man. I often have mouth ulcers, which come and go a few weeks to a month apart.

Multiple ulcers often appear at one go, and last for a week or two.

I have consulted a Western doctor and been told that I lack vitamin C. But I have observed that eating plenty of fruit does not help.

What is the cause of mouth ulcers and how do I minimise them?

A: Recurring mouth ulcers, medically termed as aphthous stomatitis, is a common condition where benign and non-contagious mouth ulcers crop up repeatedly.


Symptoms include a burning sensation, stinging and pain that are worsened by physical contact, such as with certain foods and drinks.

In traditional Chinese medicine (TCM), this problem is linked to deficiencies in the spleen, heart, liver and kidneys.

The spleen transports and transforms nutrients into qi (vital energy) and blood.

Over-exertion, drinking too many cold beverages and chronic illnesses can weaken its function.

An impaired spleen then converts nutrients into phlegm and dampness, which travel along the meridians to the mouth. Meridians are channels through which qi travels.

The person may then have a few ulcers that appear grey and dull.

A weakened spleen can go on to affect one's kidney yin. This may lead to chronic ulcers that come with a small degree of burning pain.

Heat in the body is often linked to mouth ulcers, too. Internal heat is created, for instance, when phlegm and dampness are allowed to accumulate in the body.

This heat, together with phlegm and pathogens like wind, heat and dampness, causes mouth ulcers of different shapes and sizes to form.

Ulcers can also stem from a lack of blood. This can come about if you are often anxious or worried, or if you have conditions like anaemia.

Heart fire is created, giving rise to painful mouth ulcers that appear in a small area of the mouth.

And the liver, when faced with a lack of qi and blood produced by the spleen, can indirectly cause mouth ulcers as well. This is because when liver qi stagnates, liver heat and fire is created. This can trigger painful ulcers on the sides of the tongue.

Heart fire and liver fire can also dry up one's kidney yin and cause chronic ulcers.


You can strengthen your spleen by taking herbs like milkvetch root, codonopsis root and dried tangerine peel. They help to reduce phlegm and dampness in the body.

Tackle heat and dampness with gypsum, divaricate saposhnikvia root and cablin patchouli.

If your ulcers are traced to heart fire, try golden thread lophathrum herb, common anemarrhena rhizome and oriental waterplantain rhizome. To quell liver heat and fire, take cape jasmine fruit, tree peony bar and white peony root.

Finally, you may boost kidney yin with processed rehmannia root, barbary wolfberry fruit and asiatic cornelian cherry fruit.

In addition, take small meals regularly and eat easily digested food, such as porridge and soups, to strengthen your spleen function.

Reduce your stress level, avoid negative emotions and exercise regularly. This will help to improve the circulation of qi and blood.

Get good-quality sleep to increase yin and reduce heat and fire in the body.

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A version of this article appeared in the print edition of The Straits Times on July 21, 2015, with the headline What's causing my mouth ulcers?. Subscribe