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Crohn's Disease Forum » Tests for IBD » Can canker sores in the mouth be biopsied to diagnose Crohn's?


10-09-2012, 10:45 PM   #1
ginnyrdhap
 
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Can canker sores in the mouth be biopsied to diagnose Crohn's?

I'm currently undiagnosed and will be doing a pillcam test in 4 weeks to check for possible crohn's that has not been found yet with CT scan, UGI/SBFT, and colonoscopy. But I currently have 2 large painful canker sores in my mouth and just started wondering if they could be biopsied. I read that Crohn's can occur anywhere in the digestive tract between the mouth to the anus. So, maybe this is a crazy question, but I just wonder if these sores might just be the same kind of ulcers that are biopsied in the intestines. If this is possible to do, would a GI doctor have to do it or could my primary doctor or even dentist to the biopsy???? Any feedback on this would be appreciated. Thanks!
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Last edited by ginnyrdhap; 10-10-2012 at 12:50 AM.
10-10-2012, 09:30 AM   #2
SusanB
 
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Hi ginnyrdhap!
All I can say is go to the Dr. immediately because if its Crohns it will only get worse! Sorry to be so dramatic but thats how mine started and I 'sat on the fence' and ended up really sick ( yes, from mouth to anus) and they are the same ulsers that are in your bowels. I've since had 5 surgeries and 27 inches of bowel removed. Please dont wait. Take care of it now.
Please let me know how you make out
10-10-2012, 10:43 AM   #3
ginnyrdhap
 
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Hi SusanB:
Thanks for your concern. I've been seeing doctors for 2 months now trying to get diagnosed. The only positive test I've had so far is the newest, 4th generation Prometheus Diagnostic sgi blood test that said I have a pattern consistent with Crohn's and then the prognostic part of the test said I had a 50% risk of having complications in 5 years. My GI just said these tests can be wrong and he doubts I have Crohn's due to my symptoms and other normal blood work. We've ruled out many other possible conditions so I really think it's Crohn's. My GI is on another vacation so I can't get in to see him again for 2 weeks, then he's got to order the pill cam, which I can't do for another 2 weeks due to preauthorization rules of my insurance, then the nurse said it takes the Dr. up to 3 weeks to view the 8 hours of footage from the pill cam! So I might not get a diagnosis for another 7 weeks! This is why I'm wondering if the mouth ulcers could be biopsied now to see if they are from Crohn's. Does anyone know the answer? I guess I'll call my oral surgeon when his office opens today and see what he thinks.
10-13-2012, 12:07 PM   #4
ginnyrdhap
 
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Well, I guess my bright idea about biopsying a oral canker sore was too good to be true. The oral surgeon checked with his pathologist who said it would NOT be beneficial in terms of diagnosing Crohn's. It would just show inflammation of unknown origin. They would not see the granulomas seen in intestinal ulcers. Darn it!

So next step for me is Pillcam.

Last edited by ginnyrdhap; 10-13-2012 at 01:03 PM. Reason: misspelling
10-13-2012, 10:12 PM   #5
kiny
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Like you found out, they can't. A number of diseases can have mouth issues and intestinal issues (intestinal tuberculosis for example). The reason they do biopsies is to check for possible granuloma (not always present, but if they are it's a good way to differentiate between intestinal TB and crohn) and they can do a few ELISA tests on the biopsy to differentiate between crohn and other infectious diseases.

The biopsy is not meant to check if you have inflammation or possibly crohn, they can see inflammation through blood screening, but the biopsy is meant to differentiate between other possible candidates like TB.

Many researchers are interested in mouth ulcers related to crohn though, since there are a number of ways that ulcers form, some form from the inside out, some from the outside in. If you would swallow something very acidic, you could get a mouth ulcer, that's an outside in mouth ulcer (the substance came from the outside and created the ucler inside your mouth), but if you have a bacteria, and develop mouth ulcers, that's an inside out mouth ulcer (the bacteria was present in the body and created inflammation from the inside which had clinical effect on the outside, your mouth). There is a study that tried to find out if crohn is outside in or inside out.

Why this inside-out, or outside-in, is important is to know if the body is promoting the inflammation through T cells on their own, or if some substance or bacteria on the gut lining is promoting inflammation in crohn's disease.
10-13-2012, 11:01 PM   #6
ginnyrdhap
 
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Thanks Kiny. Very interesting!
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