and Angela J. Yoon1
(1)
Columbia University College of Dental Medicine and Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
Gastrointestinal (GI) disorders – including celiac disease and inflammatory bowel disease (IBD), such as ulcerative colitis and Crohn’s disease – can present with intra-oral manifestations. Oral manifestations of GI disease are more common in children compared to adults. In some cases, particularly with Crohn’s disease, the oral lesions can present in the setting of subclinical GI symptoms or can even present several months to years before any GI manifestations. Oral lesions are the primary presenting sign preceding gastrointestinal symptoms in as much as 60 % of patients with Crohn’s disease.
7.1 Recurrent Aphthous-like Ulcers
Recurrent aphthous-like ulcers can be seen in patients with malabsorption syndromes such as celiac disease as well as in patients with IBS, ulcerative colitis, and Crohn’s disease.
Any patient presenting with a history of recurrent aphthous or aphthous-like ulcers should be questioned about GI symptoms – namely: GI discomfort, bloating, constipation, and diarrhea.
7.2 Pyostomatitis Vegetans
Pyostomatitis vegetans is characterized by erythematous, thickened oral mucosa with multiple pustules and superficial erosions. It is a manifestation of inflammatory bowel disease, most commonly seen in patients with ulcerative colitis.
Fig. 7.1
Pyostomatitis vegetans “snail track” mucosal pustules with background erythema of the soft palate
Fig. 7.2
Pyostomatitis vegetans “snail track” mucosal pustules with background erythema of the upper lip mucosa
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