It’s no secret that Crohn’s disease can be a major pain for your bowels — but it can also cause symptoms in areas outside the digestive tract. Another common side effect of Crohn’s is mouth ulcers (aka canker sores).

Folks with Crohn’s (especially kids) can also experience mouth ulcers during or before experiencing other Crohn’s symptoms. Here’s what to know.

Are mouth ulcers a side effect of Crohn’s disease?

Mouth sores are a relatively common side effect of Crohn’s disease. According to a 2013 research review, up to 50 percent of people with Crohn’s deal with mouth ulcers at some point.

Ulcers may emerge due to inflammation or nutrient deficiencies associated with Crohn’s. It can also happen as a side effect of Crohn’s disease meds.

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Crohn’s disease is a type of inflammatory bowel disease (IBD) that causes inflammation of the gastrointestinal (GI) tract, which can lead to stomach pain and issues with digestion. But symptoms of the disease also often go down outside the GI tract, which docs call extraintestinal manifestations.

Ulcers caused by Crohn’s emerge around the base of the gums. They’re different from the kind people get from herpes, which typically show up on the outside of the mouth and lips.

Crohn’s disease mouth sores typically look:

  • round
  • yellow or grayish
  • have a red border
  • small in size (usually just a few centimeters)
  • painful to touch
  • appear in clusters

Mouth sores may get worse during flare-ups or might appear before your gut symptoms onset. Minor mouth sores can take up to 2 weeks to heal, while large ulcers can take up to 6 weeks.

And although it’s pretty rare, Crohn’s can sometimes cause mouth pustules or ulcers filled with fluid (aka pyostomatitis vegetans).

General inflammation associated with Crohn’s

Research from 2013 showed that men and children with Crohn’s are more likely than women to get mouth ulcers. People with Crohn’s are also more likely to get ulcers compared to folks with other inflammatory bowel conditions like ulcerative colitis.

Vitamin and mineral deficiencies

If you have Crohn’s, you often have a greater chance of certain nutritional deficiencies that could potentially lead to (or worsen) mouth probs. Research estimates up to 85 percent of folks with Crohn’s deal with malnutrition symptoms.

A vitamin K deficiency can also cause bleeding gums. And being short on vitamin B12 or zinc can cause glossitis, a condition that leads to tongue swelling and redness.

Crohn’s disease medications

Mouth ulcers can also be a side effect of medications taken to help Crohn’s and related symptoms. Medications that may cause mouth-related side effects include:

  • Tacrolimus: ulcers and oral thrush
  • Cyclosporine: gum swelling
  • Budenoside: tongue redness and swelling
  • Loperamide: dry mouth
  • Methotrexate: ulcers and gum disease

If you’re taking medication for Crohn’s and have any of these side effects, talk with your doctor. They can help you decide if you should switch up your treatment.

Crohn’s disease can cause other uncomfy and downright painful mouth probs like:

  • bad breath
  • tooth decay (often from vomiting or acid reflux)
  • bleeding gums
  • dry mouth (which can get worse with tooth decay)
  • lip inflammation
  • tongue inflammation or redness
  • scales, redness, or discoloration around the lips

So, are your mouth ulcers Crohn’s-related? The following pics may help find out what’s going on with your mouth.

Reducing inflammation throughout the body can help treat mouth ulcers and Crohn’s in general. And because mouth ulcers are an extraintestinal manifestation (EIM) of Crohn’s, treating the disease itself will also typically help you get rid of mouth sores.

Your doc may prescribe any of the following to treat mouth sores directly or help prevent flare-ups:

  • Aminosalicylates can reduce inflammation.
  • Immunomodulators may reduce an overactive immune system.
  • Biologic therapy might neutralize immune system proteins (often via infusion).
  • Corticosteroids could decrease inflammation and reduce immune system activity.
  • Bowel rest may ease symptoms.
  • Surgery can remove the part of the intestine that causes issues.

Lifestyle and dietary changes may also help treat the ulcers and Crohn’s in general. Potential remedies include:

  • Vitamin and mineral supplements. Your doctor may recommend supplements including vitamin B12, iron, zinc, or folate to address potential nutritional deficiencies.
  • Salt rinses. As long as your ulcers aren’t open wounds, try swishing with warm water and a dash of sea salt. The salt may ease swelling by killing bad bacteria. If your sores are open, skip this, as the salt could burn the area and really hurt.
  • Keep A+ oral hygiene. Staying on top of brushing, gentle flossing, and drinking plenty of water can help soothe symptoms.
  • Start a food journal. Although there’s limited research on the link between Crohn’s and diet, some experts think certain foods trigger inflammation in the body. With the support of your doctor, consider starting a food journal to identify potential triggers.
  • Try to stop smoking. According to the CDC, smoking worsens treatment outcomes and causes increased flare-ups in people with Crohn’s.
  • Maybe try CBD. There’s some research to suggest that CBD can help relieve intestinal inflammation and support a healthy intestinal barrier. That being said, in a small study involving people with Crohn’s, participants who took CBD twice daily for 8 weeks saw no improvements. Get your doc’s approval before trying.
  • Probiotics and prebiotics. Though the research is slim, there’s some evidence that probiotics or prebiotics can help relieve pain from mouth sores.

Crohn’s disease can cause painful mouth ulcers and other oral symptoms. Medical treatments and home remedies can help ease discomfort and treat the wider issue of inflammation in the body.

If you have mouth sores you think could be caused by Crohn’s, talk with your doctor to get a diagnosis. They can help you figure out if a vitamin deficiency or your medications are to blame, and help you come up with the right treatment plan.