Oral manifestations of gastrointestinal disorders

Abstract

BackgroundA considerable number of gastrointestinal disorders (GIDs) of varied nature (inflammatory, infectious, genetic and other etiology) may produce alterations in the hard and soft oral tissues. Among these are Crohn’s disease, ulcerative colitis, celiac and gastroesophageal reflux disease.Material and MethodsArticle search was done using the National library of medicine (PubMed) database using different search terms and analyzed according to their importance.ResultsA large variety of GIDs can give rise to oral lesions, including: RAS like ulceration, mucosal tags, cobblestoning, mucogingivitis, labial and facial swelling, pyostomatitis vegetans, disgeusia and dental abnormalities, among others. Although in most cases the gastrointestinal signs and symptoms highlight in the clinical picture, a considerable percentage of these patients are affected by oral manifestations before the onset of gastrointestinal symptoms. This lesions can cause significant functional and aesthetics damages as well deteriorate the patient quality of life.ConclusionsAlthough the frequency of oral manifestations is variable across GIDs and in most cases is non-specific, these alterations may precede the underlying disease and therefore can facilitate an opportune diagnosis. Key words:Gastrointestinal disorders, oral lesions, oral mucosal disorders.

Cheilitis and gingivitis as first signs of Crohn's disease in a pediatric patient

“…The true etiology of CD still remains unknown . The prevalence of oral manifestations is ranging from 10% to 80%; clinical signs can be specific (diffuse lip, buccal swelling, tags, cobblestones) and nonspecific (aphthous ulcers, pyostomatitis vegetans, gingivitis) and might precede or coincide with intestinal inflammation …”

Angular cheilitis and oral pigmentation as early detection of Peutz-Jeghers syndrome

“…On occasion, the oral lesions are similar to gastrointestinal lesions while, at other times, oral changes are caused by gastrointestinal disease which results in malabsorption disorders. 9 Lesions can also occur in other extraintestinal tissue such that in the kidneys, ureter, gall bladder, bronchial tree and nasal passages. 1 The cause of PJS is related to the mutation of the STK11/ LKB1 (serine/threonine kinase 11) tumor suppressor gene located in chromosome 19p13.…”

“…The PJS polyps can also ulcerate resulting in acute blood loss or chronic anemia. 9 The patient consulted a dentist because of the degree of pain caused by the lesions at the corners of his mouth and the accompanying difficulty in eating and talking. Angular cheilitis, as a side-effect of chronic anemia, was caused by PJS.…”

“…Oral lesions may occasionally occur before the onset of GI disease, be present during the development of the disease or persist in a worsening form after the disease has been cured. 9 Patients with PJS often have a history of intermittent abdominal pain due to small bowel intussusceptions caused by polyps usually found in the gastrointestinal tract. On occasion, the oral lesions are similar to gastrointestinal lesions while, at other times, oral changes are caused by gastrointestinal disease which results in malabsorption disorders.…”

The Effect of Celiac Disease on the Oral Cavity: A Review )

“…The oral features of celiac disease are varied and atypical, and affected patients may exhibit enamel defects, delayed tooth eruption, and impaired mandibular jaw growth [27]. Among the oral manifestations of celiac disease, enamel defects and RAS are the most common and well documented in several studies (Table 1) [29,[31][32][33][34][35][36][37][38][39][40].…”