Oral Mucosa - GIT

Question 1

What conditions can have oral manifestations?

Answer 1

GORD
Coeliac
Idiopathic inflammatory bowel disease - Crohn’s/ IC/ OFC

Question 2

What RFs associated GORD?

Answer 2

obesity, smoking and alochol

Question 3

What is GORD

Answer 3

Gastroinsterinal reflex disorder

Question 4

What causes symptoms in GORD?

Answer 4

Excess stomach acid causing dyspepsia

Question 5

What are oral affects of GORD

Answer 5

Eorsion and hallitotiss

Question 6

Tx of GORD?

Answer 6

PPI e.g omeprazole

Question 7

What is Barret’s oesophagus?

Answer 7

Pre-malginant change in GORD

Question 8

What see histologically in Barret’s oesophagus?

Answer 8

Stratified squamous epithelium becomes damaged and transforms to columnar epithelium

Question 9

What is coeliac disease?

Answer 9

Intolerance to alpha-gliadin peptides found in gluten

Question 10

Pathogenesis of coeliac disease?

Answer 10

Exposure to gluten stimulates auto-immune response = proliferation of lymphocytes causing oedema

Question 11

What does biopsy of coeliac reveal?

Answer 11

Crypt hyperplasia and villous atrophy

Question 12

What symptoms/ signs see someone w/ coeliac?

Answer 12

Diarrhoea
Wasting and loss of appetite
Abdo pain
Tirdness/ weakness

Question 13

What is linked to coeliac?

Answer 13

Dermatitis herpetiformis

Question 14

What additional features are seen in coeliac due villous atrophy?

Answer 14

Nutritional malabsorption

Low iron = anaemia

Question 15

Why get oral manifestations in coeliac?

Answer 15

Mainly due anaemia - low iron

Question 16

Oral manifestation of coeliac?

Answer 16

Ulceration 
Glossitis
Candidasis
Angular chelitis
Hypoplasia of enamel - if developing

Question 17

How dx coeliac?

Answer 17

Clinical signs and hx
Blood test - anti-gliadin abs
Endoscope
Mucosal biopsy

Question 18

What is cronh’s?

Answer 18

idiopathic inflammatory bowel disease causing granulomatous inflammation

Question 19

What part GI does Crohn’s affect?

Answer 19

All GI causing skip lesions

Question 20

What see in transmural inflammation in Crohn’s

Answer 20

Full thickness of gut wall affected
See granuloma formation w/ cobblestone appearance
Apthous like ulceration and fissue

Question 21

Clinical features Crohn’s

Answer 21

Abdo pain
Diarrhoea
Weight loss

Question 22

Oral manifestations of Crohn’s

Answer 22

Ulceration
Glossitis
Lip swelling
Cobblestone mucosa 
Fissures
Angular chelitis

Question 23

What does biopsy of Crohn’s reveal?

Answer 23

Granulomatous inflammation

Question 24

What other process can see granulomatous inflammation?

Answer 24

TC, sarcoidosis, OFG

Question 25

What in blood test would rule of sarcoidosis in Crohn's?

Answer 25

ACE levels

Question 26

What medication might you find those w/ Crohn's are on?

Answer 26

Immunosupressives e.g methotrexate, azathioprine

Question 27

What is OFG?

Answer 27

Oro-facial granulomatosis

Question 28

What is OFG?

Answer 28

Oral manifestations of Crohn's w/o gut involvement

Question 29

What is very common see OFG?

Answer 29

Lip swelling - lower lip often affected w/ midline fissure

Question 30

What component is often seen in OFC?

Answer 30

Allergic aetiology - hence exclusion diet can be used

Question 31

Where does ulcerative colitis affect?

Answer 31

Large intestine and rectum - continuous lesion, lesion doesn't affect full thickness GI

Question 32

Clinical symptoms UC

Answer 32

``` Bloody diarrhoea Pain Weight loss Tired Ankylosising spondylitis ```

Question 33

Oral manifestations UC?

Answer 33

Oral ulceration Pyostomatits vegetates Yellow pustular lesions on gingiva

Question 34

What affect can steroids have oral cavity?

Answer 34

Candida infections

Question 35

What affect can immuno suppressants have oral cavity?

Answer 35

Ulceration and infection

Question 36

What affects can H2 receptor antagonists have? e.g Ranitidine

Answer 36

Erythema multifrome | Discolouration of tongue

Question 37

What affects can PPI have?

Answer 37

Taste disturbance | Dry mouth

Question 38

What is risk associated w/ Gardner's syndrome

Answer 38

Increased risk colon cancer

Question 39

Oral manifestations Gardener's syndrome

Answer 39

Osteoma, odontomes, supernumerary teeth

Question 40

What see Peutz Jeghers syndrome?

Answer 40

Hamartomtous polyps | Pigmented maules lip and oral cavity