Mouth Sores and Celiac Disease

Oh those painful mouth sores — technically they’re called aphthous stomatitis — many of them are more commonly known as canker sores.  Now new research shows that their cause may lie much deeper than what you think.

It’s crazy how many maladies with our bodies can be traced back to undiagnosed celiac disease.  New research in BMC Gastroenterology now confirms consistent mouth sores can also  be a symptom. On Monday Reuters printed an article about the study which says for 5 percent of the celiac population their only symptom of the disease is a mouth sore.

“Aphthous stomatitis is a painful open ulcer, such as a canker sore, in the mouth that is white or yellow and surrounded by a bright red area.  They tend to reappear in times of stress and are associated with viral infections, food allergies and other conditions” — Reuters, June 29, 2009

Researchers at Tehran University of Medical Sciences in Iran studied  247 patients who had at least 3 mouth sores a year and researchers tested them for celiac disease.  Positive test results for seven patients led to an endoscopy and biopsy of the small intestine — the gold standard for diagnosing celiac disease.  While the endoscopy said only two of the patients had celiac, the biopsy proved otherwise, confirming all seven with celiac disease.

The research says these seven patients complained that they did not respond “to conventional mouth ulcer medications, including topical corticosteroids, tetracycline and colchicine.”  Of the seven patients, four started on a gluten free diet and “all showed significant improvement within 2- 6 months.”  Officially the research concluded, “Gluten-sensitive enteropathy [celiac disease] should be considered in aphthous stomatitis patients.”   Also “a lack of response to conventional treatment could be another indicator of celiac disease risk.”

Other articles support this new research

Fellow blogger Kyle Eslick at celiac-disease.com explored this issue in January.  He quoted the Expert Doctor’s Health Tips Blog when talking about a possible reason why canker sores are a problem for celiacs:

“Some experts think it’s associated with the body’s immune system. Here again it could also relate back to celiac disease because gluten flattens the villi in the small intestine and nutrients can’t be absorbed so the immune system suffers and its defenses are broken down. So nutritional deficiencies could play a part.”

Health911.com also suggests celiac as a possible cause for canker sores:

“Individuals with celiac disease – the inability to digest the gluten in some grain (wheat, oats, rye and barley) foods – have a greater incidence of canker sores. Even without celiac disease, however, a person who is prone to canker sores may be more sensitive to gluten.”

Certainly not all people with canker sores have celiac disease — just like not everyone who has liver disease or osteoporosis has celiac.  But this new research suggests that if you have canker sores and nothing helps them — maybe you should explore the possibility.  The cause could be much deeper than you think.