Oral and intestinal histopathological alterations in inflammatory bowel disease: correlation with clinical activity...

Inflammatory bowel diseases (IBD) are chronic gastrointestinal conditions that can also manifest in the "oral mucosa", affecting patients' quality of life. This study aimed to assess histopathological alterations in the oral and intestinal mucosa of individuals with IBD and explore their correlation with psychometric measures and clinical disease activity. This pilot study included 20 IBD participants (10 with Crohn's disease [CD] and 10 with ulcerative colitis [UC]) and five control cases. Biopsies of the upper lip mucosa were obtained from all participants, and intestinal biopsies from the IBD group. Anxiety, depression, and stress levels were assessed using the Depression, Anxiety, and Stress Scale (DASS-21). Intestinal mucosa histopathology was evaluated using the IBD-DCA score (CD) and Geboes Score (UC). Clinical disease activity was observed in 60% of UC cases and 50% of CD cases. Histopathological disease activity was present in 95% of IBD participants, including those clinically in remission (P = .047) and they were correlated with the classification of intestinal segments according to histological activity in DC and UC (P < .001). Chronic inflammatory cell infiltrates in the oral mucosa were more prevalent in IBD participants than controls (P = .002). A strong correlation was found between histopathological changes in the intestinal mucosa and stress levels in CD patients (P < .001). Histological activity in IBD may persist despite clinical remission. Anxiety appears to influence "(P = 0.047)" clinical disease activity, while stress correlates with intestinal inflammation in CD patients. The presence of inflammatory infiltrates in the oral mucosa and their correlation with intestinal findings suggest a possible link between the two mucosae, reinforcing the importance of integrated and multidisciplinary approaches for disease monitoring and management.