Oral mucosal findings in ambulatory patients with inflammatory bowel disease.

Abstract

A cross-sectional study was carried out among patients with ulcerative colitis (UC) and Crohn's disease (CD) in order to determine the frequency of oral mucosal lesions or conditions (OL), as well as to analyze its relationship with some clinical and laboratory parameters. Epidemiologic, clinical, and laboratory data were considered. Statistics included univariate and multivariate analyses. Ninety patients [46 (51.1%) males] were included [median age: 43 years (range 18-79 years)]. UC was diagnosed in 65 (72.2%) patients; CD in 25 (27.8%) patients; and inactive CD was detected in 78 (86.6%) patients. All patients (100%) had OL; fissured tongue was the most frequent finding [68 (75.6%)]. Furred tongue was more common in UC than in CD patients [45 (69.2%) vs. 11(44.0%); p = 0.03]; lower levels of hemoglobin were more often detected in mucosal pallor [(median (Md) =12.1 vs. 14.4g/dL); p = 0.02] than in other OLs. Higher frequency of melanosis was observed when oral rinses were used [37 (71.2%) vs. 15 (28.8%)]; p = 0.03], compared to those who did not use them. A higher risk of varix [OR: = 37.6 (95%CI: 4.7-298.9), p < 0.001], leukoedema [OR: 5.8 (95%CI: 1.4-24.2); p = 0.004], candidosis [OR: 3.9 (95%CI: 1.4-10.6); p = 0.05], fissured tongue [OR: 3.8 (95%CI: 1.2-11.5); p = 0.01], and all infectious processes analyzed collectively [OR: 3.6 (95%CI: 1.3-9.8); p = 0.03], was found in patients older than 45 years than in younger ones. Also, patients with fissured tongue presented a higher risk of having candidosis than those without this condition [OR: 6.1 (95%CI: 2.1-17.5); p = 0.007]. OLs were highly frequently observed in UC and CD patients. Age (> 45 years), low levels of hemoglobin, use of mouthwashes, among other variables, were predictive factors of OL in these patients; thus, their assessment and detection in inflammatory bowel disease should be emphasized.