Bad Breath in Crohn’s Disease: a Trivial Problem?

PDF german translation / full article

Andreas Klement

Keywords: Crohn’s disease family medicine halitosis xerostomia

Background: Oral manifestations in inflammatory bowel disease (IBD) are common. Typical symptoms can be seemingly trivial complaints such as halitosis, glossitis and dry mouth. Considerations on differential diagnostics and references to possible “red flags” are presented.Case Report: A 54-year-old patient complained of new strong halitosis, dry mouth and burning sensations on his tongue. He had been diagnosed with Crohn’s disease 15 years ago, now with terminal anus praeter, current fistula formation in the pelvic floor and complex drug therapy. The inspection of the oral cavity revealed a whitish coating on a roughly folded tongue with a deep longitudinal fissure. Local treatments were unsuccessful and histology unspecific. The complaints improved following surgical fistula excision and subsequent change of the immunosuppressive systemic therapy.Conclusions: Oral manifestations of IBD are a significant differential diagnosis of seemingly trivial oral cavity problems and should be considered, among other “red flags”, in the longterm care of IBD patients.

(State: 19.07.2018)

Latest Issue 1/2019

In Focus

  • The Results of Six Years Postgraduate Vocational Training for Primary Medical Care in Germany
  • Implementation of Data Protection Requirements in Teaching Family Medicine
  • Organ Donation – How Should Family Physicians Advise Their Patients?