Mouth Ulcers
Small, painful lumps referred to as mouth ulcers or canker sores (the name for a wide variety of mouth lesions) are the most common oral symptom of Crohn’s disease.
These sores are usually round or oval-shaped with a clear boundary and a gray or yellow center, surrounded by a reddish ring.
Canker sores from Crohn’s might at first appear similar to other mouth lesions like cold sores, and they can both be painful. But cold sores have a different cause — herpes simplex virus type 1 — and vary in the following ways:
- Canker sores are not contagious; cold sores are.
- Canker sores only appear inside the mouth; cold sores can also develop outside the mouth.
- Canker sores show as a single, rounded sore; cold sores can also appear in clusters.
Some Crohn’s disease mouth ulcers don’t cause discomfort, while others may be painful enough to affect day-to-day life.
If you have canker sores without a Crohn’s diagnosis (for example, if they’re the first symptom you have), a physician may request a complete blood count, anemia testing, and screening to rule out celiac disease, or any other diseases.
Other Mouth Symptoms of Crohn’s Disease
Besides ulcers, changes in and around the mouth that may be due to Crohn’s include:
- Angular cheilitis, which is cracked, red, sore skin at the corners of the mouth
- Gingivitis, or gum inflammation that can lead to bleeding, swelling, and redness (one of the most common mouth symptoms of Crohn’s disease in children)
- Foul-smelling breath
- Abscesses, or pus-filled lumps, that keep growing back
- Dental decay due to repeated vomiting
- Red, scaly skin around the lips
- Glossitis, or a swollen, inflamed tongue
Although these are the most common mouth symptoms of Crohn’s disease, a gastroenterologist might find it difficult to rely on them for a definitive diagnosis as they are signs of numerous conditions, not just Crohn’s.
Oral symptoms that are specific to Crohn’s disease include:
- Inflammation and redness in the groove between the cheeks and gums, an area known as the sulcus
- Long, narrow ulcers that often form straight lines in the gum, sulcus, and the insides of the cheeks
- Scar tissue on the lining of the mouth, sometimes also including small, fleshy lumps in the mouth called mucosal tags
People with Crohn’s disease are likely to have oral symptoms at the back of the throat, as well as a higher risk of lip swelling. Identifying these two symptoms together could point towards a Crohn’s diagnosis.
These symptoms may sometimes occur along with raised levels of an inflammatory protein called C-reactive protein, which suggests high levels of gut inflammation characteristic of Crohn’s disease.
