Oral Manifestations of Inflammatory Bowel Disease and the Role of Non-Invasive Surrogate Markers of Disease Activity

• Published in: Medicines (Basel, Switzerland) Vol. 7; no. 6; p. 33
• Main Authors: Ribaldone, Davide Giuseppe, Brigo, Selvaggia, Mangia, Michela, Saracco, Giorgio Maria, Astegiano, Marco, Pellicano, Rinaldo
• Format: Journal Article
• Language: English
• Published: MDPI AG 16-06-2020; MDPI
• Subjects: Biological markers; Causes of; Complications and side effects; Crohn’s disease; Demographic aspects; Development and progression; extra-intestinal manifestations; Health aspects; inflammatory bowel disease; Inflammatory bowel diseases; Microbiota (Symbiotic organisms); Oral manifestations; Oral mucosa; orofacial granulomatosis; Physiological aspects; Review; Risk factors; tag-like lesions; ulcerative colitis; Italy
• ISSN: 2305-6320; 2305-6320
• DOI: 10.3390/medicines7060033

Inflammatory bowel disease (IBD), which includes Crohn's disease (CD) and ulcerative colitis (UC), can be associated with several extra-intestinal manifestations requiring a multidisciplinary management both in terms of work-up and therapy. Oral lesions are common in patients with IBD, with a prevalence ranging from 5% to 50%. These can represent an oral location of IBD as well as a side-effect of drugs used to treat the intestinal disease. Oral manifestations, occurring in patients with IBD, can be divided in nonmalignant, specific, and non-specific ones, and malignant lesions. While there is undoubtedly a need to search for an IBD in patients with oral lesions associated with intestinal symptoms, the work-up of those with an exclusive oral lesion should be personalized. Fecal calprotectin is a non-invasive marker of intestinal inflammation and may be used to select which patients need to undergo endoscopic examination, thereby avoiding unnecessary investigations. The pharmacological armamentarium to treat oral lesions associated with IBD includes topical or systemic corticosteroids, immunosuppressive agents, and biologic drugs.