Looking in the mouth for Crohnʼs disease

Abstract

It is widely acknowledged among gastroenterologists that the oral cavity may be involved in Crohn's disease (CD). However, the specific manifestations are poorly appreciated. Although oral aphthous ulceration is probably not diagnostically useful in patients with suspected CD, disease-specific manifestations do occur and are particularly common in children presenting with CD. These manifestations can be subtle, often are subclinical, yet commonly harbor diagnostically useful material (granulomas). Orofacial granulomatosis (OFG) is conventionally used to describe patients with overt oral disease without obvious involvement of the gastrointestinal tract. However, many patients with OFG have subclinical intestinal CD or will progress to develop overt intestinal CD with time. The management of severe oral disease is challenging and lacks a clear evidence base.

Distinguishing orofacial granulomatosis from crohn's disease: Two separate disease entities?

“…Perianal involvement has also been observed in a recent study with children who have oral manifestations of CD. 26 Indeed, our findings complement this study and our patients with CD and perianal involvement were more likely to present with oral onset of disease in childhood compared with adult onset. Furthermore, 4/6 of those without concurrent CD presented with childhood onset of oral symptoms.…”

Oral Cavity Condition and Selected Salivary Parameters in Children and Adolescents Suffering from Inflammatory Bowel Diseases

“…Gastroenterolodzy są świadomi występowa-nia zmian w jamie ustnej w przebiegu nieswoistych zapaleń jelit, nie doceniają jednak znaczenia ich obecności [9]. Zmiany mogą nie tylko poprzedzać zdiagnozowanie choroby, ale także zaostrzać się podczas aktywnej fazy choroby.…”

Orofacial granulomatosis in children—A challenge for diagnosis and treatment

“…There is however, no evidence that OFG is related to food allergy [7] although occasionally patients may benefit from cinnamon and benzoate-free diets [8,21,22]. Antihistamines provide no help for the OFG symptoms but in the severe phase according to clinical experience, a short course of oral prednisolone is effective.…”

“…It has been estimated that 40-50% of the young patients with OFG will eventually develop Crohn's disease, among adults the risk may be lower [8]. Of notice, Crohn's disease may manifest several years after the first symptoms of OFG.…”