Jejunal mucosal abnormalities in patients with recurrent aphthous ulceration

Area of Science:

• Gastroenterology
• Immunology
• Dietary Science

Background:

• Recurrent aphthous ulceration (RAU) is a common condition with various potential causes.
• Coeliac disease, an autoimmune disorder triggered by gluten, can manifest with gastrointestinal and extra-intestinal symptoms.

Purpose of the Study:

• To investigate the potential link between coeliac disease and troublesome recurrent aphthous ulceration.
• To evaluate the efficacy of a gluten-free diet in patients with RAU and suspected coeliac disease.

Main Methods:

• Jejunal biopsies were performed on 33 patients presenting with troublesome RAU over a one-year period.
• Patients with biopsy-confirmed flat mucosa (indicative of coeliac disease) were placed on a strict gluten-free diet.

Main Results:

• Eight out of 33 patients (approximately 24%) showed flat jejunal mucosa consistent with coeliac disease.
• All eight patients experienced complete clinical and haematological remission of RAU on a gluten-free diet.
• Aphthous ulceration did not recur in any of the treated patients.

Conclusions:

• Gluten sensitivity plays a significant aetiological role in a subset of patients with recurrent aphthous ulceration and flat jejunal mucosa.
• Jejunal biopsy is a valuable diagnostic tool for patients with RAU, particularly when coeliac disease is suspected.
• Dietary management with a gluten-free diet is effective in achieving remission of RAU in gluten-sensitive individuals.