Gastroenterology and Oral Lesions

Study Notes

Gastrointestinal Diseases Overview

Common gastrointestinal tract (GIT) diseases include Crohn’s disease, ulcerative colitis, and gastro-oesophageal reflux disease (GERD).
Understanding signs, symptoms, pathogenesis, management, and how these conditions relate to dental practice is essential.

Inflammatory Bowel Diseases (IBD)

IBD is characterized by chronic mucosal inflammation, primarily affecting the colon and rectum in ulcerative colitis.
Symptoms of ulcerative colitis include bloody diarrhea, abdominal pain, and fecal urgency.
Laboratory tests often reveal elevated inflammatory markers (ESR, CRP) and fecal calprotectin levels.

Oral Manifestations of Ulcerative Colitis

Major and minor aphthous ulcers commonly appear on buccal mucosa.
Pyostomatitis vegetans presents as purulent inflammation primarily on buccal and labial mucosa.
Hairy leukoplakia may occur, associated with HIV.

Crohn's Disease

Crohn’s disease can occur anywhere in the gastrointestinal tract, unlike ulcerative colitis.
Extra-intestinal manifestations may affect eyes, joints, mouth, and skin.

Oral Manifestations of Crohn's Disease

Persistent linear and deep ulcers, cobblestone mucosal architecture, and indurated swelling of the lips.

Dental Management of IBD

Routine dental care helps in monitoring oral health.
Oral lesions may be diagnosed and managed with topical steroids and sodium bicarbonate rinses.
Dexamethasone elixir can be used for extensive lesions.

Gastritis

Gastritis involves inflammation of the gastric mucosa, commonly linked to H. pylori infection and NSAIDs use.
Classified into acute, chronic, atrophic, and erosive gastritis.

Definitions

Acute Gastritis: Neutrophilic infiltration of the gastric mucosa.
Chronic Gastritis: Mononuclear infiltrate with loss of normal tissue architecture.
Atrophic Gastritis: Chronic inflammation leading to gland loss, often replaced by fibrosis.
Erosive Gastritis: Superficial erosions causing potential bleeding.

Peptic Ulcer Disease

Characterized by ulceration due to factors like H. pylori infection, drug-induced conditions, and mucosal pallor.

Gastroesophageal Reflux Disease (GERD)

GERD involves regurgitation of stomach contents into the esophagus, causing symptoms like heartburn and potential esophageal injury.

Risk Factors for GERD

Include smoking, caffeine and alcohol consumption, stress, obesity, pregnancy, scleroderma, sliding hiatal hernia, and asthma.

Red Flag Symptoms

Dysphagia, anemia, unintentional weight loss, and evidence of GI bleeding indicate potential complications needing referral for EGD.

Oral Manifestations of GERD

May include dysgeusia, erosion, mucosal erythema, xerostomia, and esophageal stricture.

Dental Management of GERD

Sodium bicarbonate mouth rinses can mitigate dysgeusia.
Topical fluoride applications support mineralization.
Maintain sufficient hydration and consider salivary substitutes.

Malabsorption Disorders

Pernicious Anemia: Often from Vitamin B12 deficiency due to gastric mucosa atrophy, leading to macrocytic normochromic anemia.
- Diagnosis involves serum Vitamin B12 and methylmalonic acid levels.
Oral manifestations include an inflamed "beefy red" tongue, glossitis, glossodynia, and burning mouth.

Folic Acid Deficiency Anemia

A macrocytic anemia resulting from a lack of dietary folic acid, particularly in diets low in leafy vegetables.

Description

This quiz explores the relationship between gastrointestinal diseases and oral manifestations. Participants will learn to identify common GIT diseases, their symptoms, clinical implications, and the significance of management in dental practice. Enhance your understanding of how systemic health affects oral conditions.