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Soreness and ulcers 4: due to gastrointestinal disease
Published on May 29, 2017 27 min
Other Talks in the Series: Oral & Maxillofacial Medicine
Lumps and bumps in the mouth and lips
- Dr. Nicholas Kalavrezos
- University College London Hospital, UK
Lumps and swellings of the salivary glands 1
- Prof. Emeritus John D. Langdon
- King’s College London, UK
Red lesions: autoimmune and malignant conditions
- Prof. James J. Sciubba
- The Johns Hopkins School of Medicine, USA
Sensory and motor deficits
- Dr. Dimitris Malamos
- National Organization of Health Service (IKA), Greece
White lesions - oral leukoplakia, a premalignant lesion
- Prof. Palle Holmstrup
- University of Copenhagen, Denmark
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.
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.
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.