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Feeling Down in the Mouth with Crohn’s Canker Sores?

Managing IBD

November 30, 2023

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Photography by Westend61/Getty Images

Photography by Westend61/Getty Images

by Stacey McLachlan

•••••

Medically Reviewed by:

Cynthia Taylor Chavoustie, MPAS, PA-C

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•••••

by Stacey McLachlan

•••••

Medically Reviewed by:

Cynthia Taylor Chavoustie, MPAS, PA-C

•••••

•••••

Some people with Crohn’s disease develop canker sores on their lips or in their mouth, often due to medications, nutritional deficiencies, or other factors. These sores can be annoying and painful but usually resolve quickly.

When you live with Crohn’s disease, your digestive system can take center stage. There’s so much to manage there that you might not even realize right away that this condition can affect other parts of your body too.

But then comes a stinging on the inside of your cheek or a discovery with your tongue: a mouth sore, casually appearing like an unwanted guest while you’re busy dealing with other things. Ugh, you too?

If you’re experiencing mouth sores as a symptom of Crohn’s, you’re not alone. Mouth sores can affect people at any stage of Crohn’s disease, and they more commonly happen during active flare-ups.

But there’s a small silver lining: There are a variety of ways you can treat mouth sores or at least ease the discomfort.

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What do Crohn’s mouth sores look like?

Crohn’s mouth sores can take various forms, and they may look different from other types of mouth sores.

Typically, they are shallow, painful ulcers with a yellow or gray center and a reddish border. If you’ve ever had canker sores (also known as aphthous ulcers), they’ll look pretty familiar.

These Crohn’s mouth sores are round or oval-shaped and can vary in size. You might have small, pinpoint lesions or larger, more extensive ulcers. Sometimes you’ll find just one, while at other times several mouth sores will appear in a group.

You may experience cobblestoning: the appearance of a group of raised, swollen bumps that line your cheeks and the space behind your lips.

Crohn’s mouth sores can commonly occur on the inside of your lips and cheeks, on your tongue, and on the roof of your mouth. They often get worse during a Crohn’s flare-up.

Crohn’s mouth sores are not contagious, unlike other types of sores you might develop around your mouth.

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What causes Crohn’s mouth sores?

Up to 9% of adults with Crohn’s (and 50–80% of children with Crohn’s) develop mouth ulcers at some point.

Research into the exact cause of Crohn’s mouth sores is ongoing. But several factors are believed to contribute to their development, including:

  • Immune system dysfunction: Crohn’s disease involves an overactive immune response, which can lead to inflammation throughout your body, including in your mouth.
  • Nutritional deficiencies: Crohn’s disease can make it more difficult for your body to absorb essential nutrients such as vitamin B12, folic acid, and iron, and this can lead to oral health issues.
  • Medication side effects: Some medications used to manage Crohn’s disease, such as azathioprine and mesalazine, may contribute to the development of mouth sores.
  • Stress and anxiety: Psychological factors such as stress and anxiety can worsen inflammation and contribute to the development of mouth sores and other Crohn’s symptoms.

How are Crohn’s mouth sores treated and managed?

There may not be a magic cure, but treatment and management of Crohn’s mouth sores can help relieve pain, promote healing, and reduce inflammation.

Talk with your doctor about the best approach. Treating your discomfort may involve a combination of medical interventions and at-home remedies.

Medical treatments

  • Topical steroids and/or anesthetics: Prescription-strength topical treatments can be applied directly to the sores to reduce inflammation and promote healing.
  • Immunomodulators: Medications that help regulate your immune system may be prescribed to address the underlying inflammation.

At-home remedies

  • Saltwater rinse: Gargling with a warm saltwater solution can help soothe and clean the sores.
  • Avoidance of irritants: Steering clear of spicy, acidic, and rough-textured foods can prevent further irritation.
  • Proper oral hygiene: Gentle brushing and flossing can help keep your mouth clean and prevent secondary infections.
  • Vitamin supplements: If your doctor thinks a vitamin deficiency may be causing your mouth sores, they may recommend taking supplements of vitamin B12, zinc, or iron.
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FAQ

How long do Crohn’s mouth sores typically last?

The duration of mouth sores can vary widely, but they often go away within 2 weeks. Severe sores may take longer to heal.

Can Crohn’s disease cause other symptoms in your mouth?

Yes, Crohn’s disease can cause other symptoms in your mouth beyond mouth sores. These may include:

  • Swollen gums: Inflammation associated with Crohn’s disease can extend to your gums, leading to redness, swelling, and tenderness.
  • Dry mouth: Some people with Crohn’s may experience reduced saliva production, which can result in dry mouth. This can cause discomfort, difficulty swallowing, and an increased risk of dental issues.
  • Cracked lips: Dryness and inflammation can cause your lips to become dry and cracked.
  • Swelling of your inner cheeks: The lining of your inner cheeks (medically known as the buccal mucosa) may become swollen and inflamed.
  • Difficulty chewing and swallowing: Severe inflammation in your mouth or throat can make chewing and swallowing painful or difficult.
  • Tooth decay and erosion: Chronic inflammation and dry mouth can contribute to tooth decay and erosion, which require regular dental care.

While these symptoms can be associated with Crohn’s disease, they can also indicate other oral health issues. Therefore, if you experience any of these symptoms, it’s crucial to seek prompt medical attention for proper diagnosis and treatment.

Should I consult a healthcare professional about my mouth sores?

Yes, it’s advisable to seek medical advice for proper diagnosis and treatment, especially if the sores are severe, recurrent, or accompanied by other concerning symptoms.

The takeaway

Crohn’s mouth sores are just one of the possible extraintestinal manifestations of the condition. But you can effectively manage Crohn’s mouth sores with a combination of medical treatments and at-home remedies. Talk with your doctor about a treatment plan that works for you.

Medically reviewed on November 30, 2023

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About the author

Stacey McLachlan

Stacey McLachlan is a writer, editor from Vancouver, B.C. specializing in design, food and travel writing. She earned her BA in Communications from Simon Fraser University and is editor-at-large for Western Living and Vancouver magazines. Stacey is a regular contributor to Dwell and has been published by the Globe and Mail, Montecristo, and Healthline, among other outlets. Find her on her website.

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