Oral Crohn's is a less common form of Crohn's disease where ulceration occurs in and around the mouth usually with some involvement of Crohn’s in the bowel.
Crohn’s disease is a chronic inflammatory disease of any part of the gastrointestinal tract. In oral Crohn’s the affected site is the face and mouth. Oral Crohn’s disease is one of a number of conditions sometimes known as orofacial granulomatosis (OFG).
Oral Crohn’s can occur on its own and more than 60% on first presentation do not have gut disease. Of those, over a ten year period, approx. 30% will go on to develop gut symptoms. Most patients with oral Crohn’s developed it after Crohn’s in their gut. However, most of those with gut Crohn’s will not develop oral Crohn’s.
Common features are facial and lip swelling with soreness and cracking at the corners of the mouth (called angular stomatitis). It can include mouth ulcers, gum swellings (hyperplasia) and redness. Under a microscope, oral Crohn’s looks exactly like gut Crohn’s.
diagnosing oral Crohn's
Most oral medicine consultants deal with oral Crohn’s so ask your doctor to refer you to the nearest teaching hospital. They will ask you questions about your child’s mouth and gut and also take a dietary history. They will take a biopsy (small sample) and will also do patch testing to exclude allergy to common foods or additives.
treatments for oral Crohn's
Most children and teenagers are worried by the appearance but whether you have gut lesions or not, some treatment can be given, and include:
- exclusion diet - this tries to reduce the intake of food which may make the swelling worse
- mouthwash or paste for mouth ulcers
- injections into the swelling on lips or cheeks to try to improve the appearance. This usually results in a good cosmetic result.
- it is not a good idea to have cosmetic surgery as the swelling returns quickly and lots of scarring may occur. Surgery may sometimes be necessary but should always be done with a doctor's input.