Answer

Dear XXXXXXX,

Inflammatory bowel disease is variable in its clinical presentation-- sometimes its called Crohn's, sometimes ulcerative colitis, and somtimes unspecified. Regardless of what name is attached to it, it is usually related to some auto-immune process, which is consistent with your other diagnoses of RA and Sjogren's syndrome.

Too often these inflammatory digestive disorders are pegged to a particular anatomical part-- ulcerative colitis to the colon (naturally), and Crohn's to the ileum. However, the same underlying disease process can occur to a greater or lesser extent anywhere in the digestive tract-- including the mouth. It is an established fact that patients who suffer with Crohn's disease sometimes have lesions in the mouth that, when examined microscopically, are quite similar to tissue retrieved from Crohn's lesions in the intestine.

Now, that doesn't mean that what you have in your mouth is an extension of your "unspecified" inflammatory bowel disease. However, it is certainly one of the diagnoses that should be investigated, given your medical history.

There are other conditions that should be considered as well-- conditions that are thought to also have some auto-immune basis, such as pemphigoid or erosive lichen planus, to name just two. Most of these conditions are managed much as your bowel disease is managed-- with anti-inflammatory or immunosuppressive medication.

Since you're already a patient at the University of Michigan, you might give some thought to contacting someone at the School of Dentistry Department of Oral Pathology. Oral pathologists have a real knack for diagnosing and managing oral conditions that evade other clincians.

To find an oral pathologist at the dental school, call:
(XXX) XXX-XXXX or Toll Free 1-888-707-2500

Hope this helps...

Expert:	Mark Bornfeld
Pos. Feedback:	98.2 %
Accepts:
Answered:	6/29/2007

Dentist (DDS or equivalent)

32 years private practice experience in general dentistry, member Academy of General Dentistry, ADA