Understanding Mouth Ulcers in Ulcerative Colitis

Today, I want to talk about the relationship between ulcerative colitis (UC) and mouth ulcers, highlighting the challenges faced and sharing practical strategies for coping with this aspect of the condition.

Mouth ulcers might be considered more prevalent in Crohn’s disease, due to the mouth to anus involvement. However, mouth ulcers are still a significant concern for those of us living with ulcerative colitis (UC), too.

NSAIDs and mouth ulcers

While I don’t experience mouth ulcers on a day-to-day basis, the introduction of non-steroidal anti-inflammatory drugs (NSAIDs) always promptly triggers their arrival. For me to allow NSAIDs anywhere near me, I have to be desperate.

The trouble is, thanks to secondary fibromyalgia (cheers for that, IBD), I find myself feeling desperate quite frequently. I experience widespread pain daily and feel I have limited options in terms of pain relief. I use weird and wonderful herbal balms and take hot baths, but it's simply not realistic when it's time for bed to hop in the bath, and the balms only do so much.

Yoga helps me but I do that first thing in the morning, and by the time the evening arrives I am usually experiencing much higher pain levels. This often results in me applying a pain relieving gel which contains an NSAID, in an attempt to get comfortable enough to fall asleep.

Then, guess what?! Mouth ulcers appear, fast! Thankfully, I generally manage to avoid oral NSAID intake, at least! In my experience, specialists usually advise people with IBD to steer well clear.

Community insights

Discussions within the IBD community have shed light on the wide range of experiences and responses to mouth ulcers and NSAIDs. While some people say they have no issues with NSAID use, others, like myself, have experienced adverse reactions such as mouth ulcers and increased symptoms. 

Personally, as soon as I feel that familiar tingle and/or stinging, I’m straight off to investigate. I usually already know the outcome, depending on whether I've needed to use the pain-relieving gel!

I will admit, I feel really frustrated by this cycle. If I'd not been diagnosed with UC then I'd probably not have fibromyalgia, and it's the fibromyalgia that makes applying the NSAID pain relief gel necessary in the first place. If I didn't have IBD then I probably wouldn't be as sensitive to the NSAIDs either!

I know, there's a lot of "probably" there, and I'll never really know, nor can I change anything. Still, that doesn't make it less frustrating!

Practical coping strategies

I've been an active member of the online IBD community for many years, so of course I've learnt a lot about the mitigating strategies of others living with IBD and mouth ulcers. I wanted to share some of the more common strategies I've observed, in case they can be of use.

Always discuss any treatments with your doctor to determine the best and safest options for you. These are options that I find helpful for mouth ulcers:

• Saltwater gargles: A simple and effective way to promote oral hygiene and alleviate discomfort associated with mouth ulcers.
• Topical treatments such as Bonjela and Anbesol Liquid: These products offer numbing and/or antiseptic properties, providing temporary relief from pain and promoting healing.
• Hydrocortisone buccal tablets: These tablets, containing hydrocortisone (commonly know as a steroid), adhere to the inside of the mouth, releasing medication to alleviate soreness and speed up healing.
• Difflam mouthrinse and spray: Despite its classification as an NSAID, Difflam contains benzydamine hydrochloride, serving as a locally acting analgesic and anti-inflammatory treatment for mouth ulcers.

Empowering each other

Mouth ulcers represent a significant challenge for people living with ulcerative colitis, often exacerbated by the use of NSAIDs. However, by sharing our experiences, insights, and coping strategies within the community, we can better understand and manage this aspect of the condition. Through collaboration and support, we can empower each other to navigate the complexities of UC and improve our overall well-being.

If you have tips to share, please let me know in the comments. Your insights will add to our collective knowledge and may ultimately help someone else!