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 few conditions sometimes known as orofacial granulomatosis (OFG).
Symptoms of Oral Crohn's
- Common features of the disease are facial and lip swelling with soreness and cracking at the corners of the mouth (called angular stomatitis)
- The cheeks and lips, and occasionally the palate, can be seen to have a cobblestone appearance
- Mucosal tags inside the mouth
- Mouth ulcers
- Gum swellings (hyperplasia) and redness
Under the Microscope (histology)
Oral Crohn’s looks exactly like gut Crohn’s
Will my child get gut Crohn's if they have Oral Crohn's?
- Not necessarily - Oral Crohn’s can occur on its own
- More than 60% on first presentation do not have gut Crohn's
- A few will go on to develop gut symptoms (30% over 10 years)
- Some patients develop oral Crohn’s after gut Crohn's
Who can I go to for advice?
- Ask your doctor to refer you to the nearest teaching hospital
- Most Oral Medicine Consultants deal with Oral Crohn’s
What will they do?
- They will ask you questions about your child’s mouth and gut and also take a dietary history
- They will take a biopsy to make a diagnosis
- They will also do patch testing to exclude allergy to common foods or additives
What is the most common worry?
- Most children and teenagers are worried by the appearance
Can Oral Crohn’s be treated?
- Yes - whether you have gut lesions or not some treatment can be given
What treatment is available?
- Exclusion diet - this tries to reduce the intake of food which may make the swelling worse. Some centres are very strict while others try and exclude specific components in the diet only.
- A 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 become necessary but should always be done in conjunction with a Consultant in Oral Medicine.