UCSF

Background: Inflammatory bowel diseases (IBDs) are a group of chronic inflammatory conditions that affect the digestive tract. The two primary types of IBD are Crohn's disease (CD) and ulcerative colitis (UC) have been reported in 1.2 million Americans. Oral manifestations of IBD are common and may cause physical and emotional discomfort in affected individuals and can significantly reduce their quality of life (QoL).

Objectives: To examine the QoL in pediatric patients with oral manifestation of IBD.

Methods: This was a single-center, prospective cross-sectional study of pediatric patients (ages 2-18) diagnosed with IBDs and oral manifestations of IBD seen at the University of California San Francisco (UCSF). The study was conducted between September 2021 and April 2023. Eligible patients or their guardians engaged in an online survey that incorporated the modified Chronic Oral Mucosal Diseases Questionnaire-15 (COMDQ-15). This tool was designed to gauge the effects of oral diseases on their quality of life, probing into domains such as physical discomfort, medication, emotional and social repercussions, and patient support. Data were collecting using Redcap. Descriptive analyses were used to summarize the data. Responses to the COMDQ-15 were scored on a 5-point Likert scale from "not at all" (0) to "extremely" (4). Means and the standard deviations were calculated for each domain.

Results:

A total of 193 pediatric patients with oral lesions secondary to IBD were identified. Of these, 30 (15.5%) completed the survey questions. The average age of participants was 15 years, with the majority (66.7%) diagnosed with Crohn's Disease. The most commonly prescribed systemic medications for IBD were infliximab (63.3%) and adalimumab (16.7%). Oral ulcers were the most prevalent oral condition (93.3%). Questionnaire results highlighted a range of experiences, from physical discomfort to emotional impact, with (46.7%) reporting no discomfort during oral hygiene activities and (46.7%) feeling not at all emotionally impacted. The COMDQ-15 score revealed that sensitivity to spicy and acidic foods had the highest mean score (1.47 SD: ± 0.97) and patients expressed the most satisfaction with family support, averaging a score of (2.93 SD: ±1.16)

Conclusion:

Pediatric patients with IBD often present with oral lesions that may significantly compromise their QoL. Timely identification and early intervention for these lesions are paramount to improve patient's overall health and QoL. Clinicians should be cognizant of the profound repercussions of these lesions on pediatric patients' well-being and should advocate for a collaborative, multidisciplinary approach with oral medicine specialists for optimal clinical outcomes.