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  • Jefferson Adams
    Jefferson Adams

    Could that Canker Sore Mean Celiac Disease?

    Reviewed and edited by a celiac disease expert.

    Celiac.com 07/16/2009 - A small but significant number of people who suffer from aphthous stomatitis, commonly called canker sores, also suffer from celiac disease, so it makes sense to perform celiac screening these people, according to a recent study that appears in BMC Gastroenterology.

    Celiac disease is an inherited, immune system disorder in which the proteins found in wheat, rye and barley cause damage to the lining of the small intestine.

    Reports suggest that canker sores might be the sole symptom for about one in twenty people with celiac disease, according to Dr. Farhad Shahram, of Tehran University of Medical Sciences, Iran, and colleagues.

    Commonly called canker sores, aphthous stomatitis is a painful, open ulcer in the mouth that is white or yellow and surrounded by a bright red area. The sores often recur in times of stress and are associated with viral infections, food allergies and other complaints.

    The research team looked at 247 people with aphthous stomatitis, who had suffered at least three aphthous lesions in the previous year. Subjects had a median age of 33 years.

    The team screened blood samples for antibodies and other immune factors connected with celiac disease, and excluded patients with negative results. Subjects with positive blood tests underwent intestinal biopsy. A positive gluten-antibody blood test and abnormal biopsy results constituted gluten-sensitive enteropathy.

    Of the 247 patients, seven patients showed positive blood tests and submitted for upper GI endoscopy and duodenal biopsy.

    Two of the seven patients showed endoscopy results compatible with gluten-sensitive enteropathy, while five were normal. However, biopsy results for all seven showed gluten-sensitive enteropathy.

    Average age for patients with gluten-sensitive enteropathy was 27 years old, and on average suffered from the disease for 4.5 years.

    Interestingly, none of the seven celiac disease patients responded to conventional mouth ulcer medications, including topical corticosteroids, tetracycline, and colchicine.

    Four of the seven patients with celiac disease adopted a gluten-free diet, and all four showed substantial improvement within 2 to 6 months.

    As a result of the study, doctors should consider the possibility of celiac disease/gluten-sensitive enteropathy when treating patients for aphthous stomatitis patients, especially those who show a lack of response to conventional treatment, which may be another indicator of celiac disease risk.

    BMC Gastroenterology 2009, 9:44


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    Guest Bye Bye Gluten

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    I've been searching for a solution for my mouth ulcers for over 40 years. Recently, my daughter was diagnosed with a sensitivity to gluten, so I stopped eating it out of solidarity. Voila, the ulcers are gone for several months now: something I don't remember in my entire adult life. Who'd have thought?

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    I stopped eating gluten for a period of 8 months and had no canker sores. After I began eating gluten again I didn't notice their appearance immediately, rather it has taken a little while, but they are back in full swing. I agree that gluten suppresses the immune system in some people and causes a myriad of other problems. Whether or not gluten is the direct or indirect cause of no canker sores I cannot say but it is definitely worth a try!

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    Thank you Dr. Frank. I am a dental asst who has suffered from these sores for almost ten years. I am in my late 30's. I think I have celiac disease. The dentist I used to work for laughed when I would have really bad sores. Like you said...in clumps. I wanted to die. He never had an answer. He would say I was just a freak. He thought it was all in my head. I have been taking a Zinc supplement for over a year now and it helps. They are no where near as bad as they used to be. Some of them used to take weeks to heal. Sometimes even months! Now they last about a week on the Zinc. I will give a gluten free diet a try. Thanks again for posting. You changed my life tonight.

    Oh girl, we're in the same situation. My doctor diagnosed that I have celiac disease and I'm two days on the gluten-free diet.

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    I'm very thankful that I now know what causes my canker sores not to heal, instead just staying in my mouth every month and when the one heals comes the other... I don't like when my sores will be at my tongue its very painful and I can barely talk. But two days ago, my test was positive of celiac disease. I was so happy that now I know what triggers my canker sores, and on Tuesday i will go to my gastroenterologist doctor to have an endoscopy test. I have been to the hospital twice because I can't eat at all, my mouth and my throat was full of canker sores. I like to die in that time... but thank God there's always a way to find the cause of the problem. I'm still adjusting to what I eat and looking for gluten-free products in the shop. It's not so easy, but for my own good I will stick to my diet.

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    As a dentist (retired after 30+ years) and a sufferer of cancer sores for many years, I tried many remedies to no avail. I had numerous patients that had outbreaks much worse than mine.

    Most had to "suck it up" and bear the pain. I researched out cures but never found anything in the literature (both medical and dental- I had full access to both the AMA and ADA web sites). I had been told they were from "stress". I was a long distance runner and noticed that after long workouts and hard training that they were more frequent. As I remember what foods that I was consuming after these workouts, I now realize that it was the huge quantities of gluten that caused the outbreaks.

    My epithany came in July'05 when I was diagnosed with Celiac disease (age 62) and started my new gluten free diet. To date, I have not had a full blown outbreak, only small localized ulcers that heal within 1-2 days. (probably from contamination)

    In the past, if I had bitten my lip, the ensuing ulcers would last at least 1 week, but now, they're gone by the next day.

    Since I have retired, I no longer have access to these dental/medical sites and wonder if any articles have been written about the gluten intolerance/Celiac link to canker sores?? My dentist had no idea about the relationship after asking him at a recent visit.

    Anyone that gets these sores in clumps, can be in so much pain that it is debilitating - unable to eat or drink.

    I too suffered from age 11 - 30 with cankers all over mouth and throat. unable to eat or swallow. I had NO cankers for 1 or 2 days per month. AGONY! Loss time at school and missed dentist apt due to pain. If I ate something that gave me cankers, I wouldn't eat that food again. Cankers are totally food related. I went gluten free ( tested neg for celiac per biopsy and blood test) I still had no cankers UNTIL I started eating snickerdoodle cookies from Enjoy Life. Gluten free, non gmo..etc.... those darn cookies give me cankers!

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  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

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