Crohn’s disease’s oral clues for timely diagnosis

Crohn’s disease (CD), a type of inflammatory bowel disease (IBD), is marked by chronic inflammation throughout the gastrointestinal tract.

Recent research featured within the Journal of Clinical Medicine delves into the oral manifestations of CD.

Study: Oral Manifestations of Crohn’s Disease: A Systematic Review. Image Credit:Depiction Images/Shutterstock.com

Insights into CD

CD predominantly impacts the lower gastrointestinal tract, particularly the ileocolonic region. It is a chronic condition characterised by periods of remission and exacerbation, affecting each men and girls equally. CD exhibits a bimodal incidence, with the primary peak between ages 20 and 40 and the second between 50 and 60.

The precise reason for CD stays elusive, but it surely’s strongly related to genetic aspects and modified immune responses.

Genomic studies have linked CD manifestations to NOD-2 receptor mutations, influencing the immune response against gut bacteria. Changes within the gut’s commensal microbiota, similar to Mycobacterium avium paratuberculosis (MAP) or measles virus, are also implicated in CD development.

Environmental aspects

Studies have linked CD to specific toothpaste decisions and a history of appendectomy. In contrast, breastfeeding and childhood contact with animals appear to supply protective aspects against CD development.

CD symptoms

CD presents as gastrointestinal inflammation, often resulting in intestinal strictures and fistulas. Common symptoms include abdominal pain, chronic diarrhea, and significant weight reduction.

The character of diarrhea may help pinpoint the affected area: large volume diarrhea suggests ileal inflammation, while smaller, bloody, and mucus-containing diarrhea often indicates colonic involvement.

Oral manifestations

Oral symptoms can function the primary signs of CD, affecting roughly 9% of adults and a striking 80% of kids with the condition. Lesions are commonly found on the lower lips and gums and, less often, within the fauces’ tongue, taste bud, uvula, and pillars.

Early oral CD symptoms include aphthous ulcers, edema, pain, and redness. In children with CD, mucogingivitis and ulcers are common.

Specific and non-specific manifestations

CD may end up in specific oral manifestations, including ulcers, granulomatous changes, and Miescher cheilitis of the lips. Mucogingivitis, oral swelling, linear and serpiginous ulcers, and cobblestoning of the oral mucosa are amongst the particular manifestations.

Non-specific manifestations involve oral erythema nodosum, multiple neutrophilic dermatoses, and aphthous ulcers.

Periodontitis and vegetating pyostomatitis have been reported in limited studies, with periodontitis related to severe CD within the adult population.

CD treatment

CD treatment primarily focuses on relieving clinical and endoscopic symptoms to stop complications like intestinal failure. Common therapies include immunomodulators, aminosalicylates, corticosteroids, and biologic therapies (e.g., infliximab, adalimumab, and ustekinumab).

The review underscores the importance of early and accurate CD diagnosis since patients are susceptible to developing colorectal, small bowel, and mucinous carcinoma. Oral manifestations play a vital role in identifying CD early.