E0408 - Oral Manifestations of Inflammatory Bowel Disease: The Temporal Relationship Between Oral and Intestinal Symptoms

Tuesday, October 25, 2022

3:00 PM – 5:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Lauren Loeb, MD

Mayo Clinic Florida
Jacksonville, FL

Lauren Loeb, MD¹, Marketa Janovska, ², Katherine Bodiford, MD¹, Nabil El Hage Chehade, MD³, Yaohua Ma, ¹, Habeeba Siddiqui, ¹, Benjamin McCormick, MD¹, Roy Rogers, MD¹, Francis A. Farraye, MD, MSc⁴, Christina Ha, MD⁵, Jana G. Hashash, MD, MSc¹
¹Mayo Clinic Florida, Jacksonville, FL; ²Institute of Dental Medicine, General University Hospital and First Faculty of Medicine, Charles University, Prague, Hlavni mesto Praha, Czech Republic; ³MetroHealth Medical Center, Cleveland, OH; ⁴Mayo Clinic, Jacksonville, FL; ⁵Mayo Clinic, Scottsdale, AZ

Introduction: Inflammatory Bowel Disease (IBD), including both Crohn’s Disease (CD) and Ulcerative Colitis (UC) are chronic relapsing remitting gastrointestinal (GI) disorders that may present with variable symptoms including extraintestinal manifestations (EIMs). The clinical course of EIMs involving the oral cavity can range from asymptomatic to painful, debilitating symptoms and may impact the overall IBD treatment plan. Increased knowledge of the timing and synchronicity of the oral manifestations (OMs) of IBD allows for optimized medical management. We aim to describe our real-world experience of the role of OMs in predicting or accompanying flares of GI inflammation and the impact they may have in the treatment strategy of IBD.

Methods: A retrospective review of electronic medical records at a tri-state tertiary academic medical center for adult patients with IBD from 1/2017 to present who exhibit at least one OM of IBD was performed. Wilcoxon rank sum test for continuous measures and Fisher’s Exact test for categorical measures were performed to identify the relationship between development of OMs and IBD flares and the morphology of OMs.

Results: 119 adult IBD patients with OMs included 71 females (59.7%) and 48 males (40.3%) with a median age of 35 (range:18-78) years. Most common OMs identified included aphthous ulcers, mucositis, and stomatitis. Table 1 shows the relationship between active IBD flares and OMs. Based on the results, OMs were significantly synchronous with CD activity in the esophagus (8.5%, p=0.039), gastro-duodenum (10.6%, p=0.017), small intestine (42.6%, p< 0.001) and large intestine (36.2%, p< 0.001). UC pancolitis (17%, p=0.04) was significantly synchronous with OMs.

Discussion: IBD can be complicated by various EIMs, including a variety of oral diagnoses. This study provides evidence that IBD patients were significantly more likely to have OM flares synchronous with IBD flares. Further analysis will be completed on other factors surrounding OM presentation and management including OMs despite certain IBD treatment.

	OM Flares Synchronous with IBD Flare
CD Esophageal Flare	4 (8.5%), p= 0.039
CD Gastroduodenal Flare	5 (10.6%), p= 0.017
CD Small Intestine Flare	20 (42.6%), p< 0.001
CD Large Intestine Flare	17 (36.2%), p< 0.001
UC Pancolitis Flare	8 (17.0%), p=0.040

Disclosures:

Lauren Loeb indicated no relevant financial relationships.

Marketa Janovska indicated no relevant financial relationships.

Katherine Bodiford indicated no relevant financial relationships.

Nabil El Hage Chehade indicated no relevant financial relationships.

Yaohua Ma indicated no relevant financial relationships.

Habeeba Siddiqui indicated no relevant financial relationships.

Benjamin McCormick indicated no relevant financial relationships.

Roy Rogers indicated no relevant financial relationships.

Francis Farraye: Adiso Therapeutics – DSMB. BMS – Advisory Committee/Board Member. Braintree Labs – Advisory Committee/Board Member. GSK – Advisory Committee/Board Member. IBD Educational Group – Advisory Committee/Board Member. Innovation Pharmaceuticals – Stock Options. Iterative Scopes – Advisory Committee/Board Member. Janssen – Advisory Committee/Board Member. Lilly – DSMB. Pfizer – Advisory Committee/Board Member. Sebela – Advisory Committee/Board Member. Theravance – DSMB.

Christina Ha: Abbvie – Advisor or Review Panel Member, Advisory Committee/Board Member. Bristol Myers Squibb – Advisory Committee/Board Member. Index Pharmaceuticals – Advisory Committee/Board Member. Janssen – Advisory Committee/Board Member. Pfizer – Advisory Committee/Board Member, Grant/Research Support. Takeda – Advisory Committee/Board Member.

Jana Hashash indicated no relevant financial relationships.

Lauren Loeb, MD¹, Marketa Janovska, ², Katherine Bodiford, MD¹, Nabil El Hage Chehade, MD³, Yaohua Ma, ¹, Habeeba Siddiqui, ¹, Benjamin McCormick, MD¹, Roy Rogers, MD¹, Francis A. Farraye, MD, MSc⁴, Christina Ha, MD⁵, Jana G. Hashash, MD, MSc¹. E0408 - Oral Manifestations of Inflammatory Bowel Disease: The Temporal Relationship Between Oral and Intestinal Symptoms, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.