Kuraitby Shahed, ALhomsi Alaa, Aljoujou Abeer A
Department of Oral Medicine, Faculty of Dental Medicine, Damascus University, Damascus, Syria.
Medicine (Baltimore). 2025 Jul 18;104(29):e43336. doi: 10.1097/MD.0000000000043336.
RATIONALE: Inflammatory bowel diseases like Crohn's disease can manifest with oral ulcers that negatively impact quality of life. Managing these stubborn symptomatic lesions requires an integrated medical and dental approach. PATIENT CONCERNS: A 23-year-old male was diagnosed with Crohn's disease 3 years ago. He was referred to the oral medicine department due to a painful 3 cm ulcer on the dorsum of the tip of his tongue, which was interfering with his ability to eat and drink. DIAGNOSES: A gastrointestinal endoscopy revealed a rectal ulcer, a cecal ulcer, superficial erosion, and scattered millimetric warts in the rectal area. INTERVENTIONS: The patient was treated with a daily dose of azathioprine (50 mg) for 2 years. Once the clinical symptoms improved, the medication was discontinued. The major aphthous ulcer was managed with a combined treatment of 0.1% triamcinolone acetonide oral base and photobiomodulation laser therapy. OUTCOMES: This dual therapy approach aimed to reduce pain, accelerate healing, and prevent scarring. LESSONS: Collaborative care between gastroenterology and dentistry led to better symptom control and clinical outcomes for this patient with miserable mouth ulcers from Crohn's disease. The case highlights the benefits of a transdisciplinary treatment strategy targeting both oral and intestinal manifestations of inflammatory bowel disorders.
理论依据:像克罗恩病这样的炎症性肠病可能会出现口腔溃疡,对生活质量产生负面影响。处理这些顽固的症状性病变需要医学和牙科的综合方法。 患者关注:一名23岁男性3年前被诊断为克罗恩病。他因舌尖背部有一个3厘米的疼痛性溃疡而被转诊至口腔内科,该溃疡影响了他的进食和饮水能力。 诊断:胃肠内镜检查发现直肠溃疡、盲肠溃疡、浅表糜烂以及直肠区域散在的毫米级疣。 干预措施:患者接受了为期2年的每日剂量硫唑嘌呤(50毫克)治疗。临床症状改善后,停药。对重型阿弗他溃疡采用0.1%曲安奈德口腔糊剂和光生物调节激光治疗相结合的方法。 结果:这种双重治疗方法旨在减轻疼痛、加速愈合并防止瘢痕形成。 经验教训:胃肠病学和牙科之间的协作护理为这名患有克罗恩病导致痛苦口腔溃疡的患者带来了更好的症状控制和临床结果。该病例凸显了针对炎症性肠病口腔和肠道表现的跨学科治疗策略的益处。
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