Brief Answer: RAS with ulcerations, rule out systemic illness Detailed Answer: Good Day Madam! My name is Dr S Khan and i read your concern about recurrent sores/ aphthous ulcers and cramps with history of ulceration. Superseded by hypertension history and deranged lipid profile and last but not the least geriatric limitations of 58 years. Madam i want you to know that ulceration of that frequency and recurrence with muscle spasms( neck stiffness) needs work up as this might be a presentation of some systemic disease like Lupus. I said it just to be on the safe road. There is no harm in getting screened for systemic illnesses. Once clear all you would need would be modifications in diet and lifestyle. Now as far as cramps are concerned they need increased fibre intake, easily digestible diet, plenty of fluids, antispasmodics like phloroglucinols, Antacids like omeprazoles etc, avoidance of stimulants like coffee, tea, chocolate tomato spices etc, increasing the intervals between sleep and eating.losing weight( but gaining and keeping it below 25 BMI in your case as you already are very weak) and elevating the head side of the bed t least 8 inches.avoidance of Unnecessary pain medications specially NSAIDs. Consult with gastroenterologist for diagnostic studies to rule out IBS and other age related gastric morbidities. Now the recurrent aphthous ulcers as i said may be the indication of systemic illnesses and you might need a rheumatologist for that work up. but right now you can treat symptoms. Oral vitamin B12 intake, topical oral steroid gels, topical tetracyclins ,Chlorhexidine gluconate and bioadhesive (Gelclair) mouth rinses , garlic water mouth rinses,Topical anti inflammatory agents like benzydamine and amlexanox would get you through these symptoms. brush your teeth softly and slowly as they might be the reason for recurrent ulcers, keep the good oral hygiene , say in touch with your dentist and you would not have to worry about it any more. Hope you got what you were looking for. If you have any more queries please feel free to ask other wise i request you to kindly close the discussion and rate the answer as per your experience. Take some very good care of yourself and may the odds be ever in your favour. Regards Dr S Khan

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