0:00
Hi, there. My name is Dr. Rachel Cowie.
I'm a doctor based in Bristol,
United Kingdom,
and I work between the Oral Medicine Department of the Bristol Dental Hospital
and the Acute Medical Unit
of the Bristol Royal Infirmary,
where I work
in a largely teaching capacity.
I'm going to spend the next 45 minutes or so
talking about soreness
and oral ulceration secondary
due to gastrointestinal disease.
0:24
Now, there are
a plenty of gastrointestinal conditions
can affect the mouth
and present with oral problems,
esophageal webs, esophageal stricturing,
gastroesophageal reflux disease,
or more unusual conditions
such as Gardner's syndrome
or Peutz-Jegher syndrome.
However,
this talk is designed to focus on conditions
that specifically cause ulceration and soreness
and this largely involves the following the areas:
Malabsorption, celiac disease,
inflammatory bowel disease,
and metastatic disease.
I will go through each of these in turn.
0:56
So just before doing that,
it's worth reminding ourselves
as to the definition of an ulcer
which is "a break in the skin
or mucous membrane with loss of surface tissue,
disintegration,
and necrosis of epithelial tissue".
Now, this is a common definition.
Oral ulcers are usually fairly easy to see
and assess objectively
unlike soreness which is relatively
much more subjective.
The impact of oral mucosal disease
on a person's quality of life will vary greatly
according to several factors.
Obviously the presence
and severity of the mucosal disease
will be a determining factor.
However, it's important not to forget
psychosocial factors.
For example, in orofacial granulomatosis
or Crohn's disease,
when there is a marked granulomatous cheilitis
for example.
In a teenager this may cause
significant social embarrassment
and be associated with low self-confidence,
social exclusion, bullying,
and perhaps poor performance at school.
Certainly,
conditions like orofacial granulomatosis
can have quite a devastating impact
on the overall well-being
of a young child or adult.
