Mouth Ulcers and Other Oral Symptoms

Inflammatory bowel disease (IBD) is the name for chronic inflammation in the digestive tract. Two conditions fall under the IBD umbrella: ulcerative colitis (UC) and Crohn’s disease. These 2 conditions typically affect different parts of the digestive tract, or gut.¹

IBD typically causes symptoms in the gut. Symptoms might include diarrhea, stomach pain, or weight loss. But IBD also can cause other symptoms such as mouth ulcers.^1,2

What do IBD mouth ulcers look and feel like?

IBD can cause sores in the mouth called aphthous ulcers or canker sores. The sores typically form on the inside of the cheeks or lips. They also may form under the tongue.^2-4

These sores are small, shallow, and round or oval-shaped. For some people, the sores can be very painful. They may not bother other people. Mouth sores are the first sign of IBD for some people.^2-4

Mouth sores are more common in people with Crohn’s disease than people with UC. About 1 in 10 people with Crohn’s have mouth sores. Mouth sores with IBD are also more common in men and children. Sores may be more likely to appear during IBD flares. But for some people, they appear at other times.^2-4

Mouth ulcers in ulcerative colitis and Crohn's disease

Experts do not know exactly why Crohn’s or UC can cause mouth sores. Several factors can contribute to IBD mouth ulcers, including:^3-5

• Some medicines that treat IBD can cause sores as a side effect.
• IBD can cause nutritional deficiencies. Not getting enough of certain nutrients can cause mouth sores.
• IBD itself causes inflammation. This inflammation can sometimes impact the mouth, causing sores.

It is not clear why inflammation from IBD impacts the mouth in some people but not in other people. One theory is that it is related to imbalances in mouth bacteria caused by IBD.^3-5

Other oral symptoms of IBD

Along with mouth sores, IBD is also linked to other, less common, oral symptoms. These include:^3-5

• Gum disease
• Bad breath
• Pyostomatitis vegetans (PV), a rare condition that can cause small, pus-filled bumps in the mouth
• Dry mouth
• Change in taste
• Burning feeling in the mouth

Like sores, it is not always clear how IBD is related to these other symptoms. They may be related to treatment, nutrition, or IBD itself.^3-5

Managing mouth ulcers with IBD

Many times, medicines that treat inflammation in the intestine will also treat mouth sores. But there are also ways to treat mouth ulcers directly. Treatment options include:^2,3

• Rinsing your mouth with salt water
• Over-the-counter medicated rinses
• Liquid or topical steroids (to be applied directly to sores)
• Supplements to balance out nutritional deficiencies
• Avoiding very spicy, acidic, or salty foods

If you are concerned about mouth sores, talk with your doctor. Managing them may be possible with the right treatments. Treating sores also lowers the risk of them becoming infected.^2-4