Gi disease notes

Question 2

What may some H2-receptor antagonists and anticholinergics cause?

Answer 2

• Xerostomia
• Predisposition to dental caries

These medications can lead to dry mouth, increasing the risk of tooth decay.

Question 3

What are potential consequences of prolonged exposure of tissues to acid?

Answer 3

• Erythema
• Mucosal atrophy
• Fibrosis
• Stricture of esophageal mucosa

These conditions can arise from chronic acid exposure, affecting the esophagus.

Question 4

What should be periodically updated in the dental management of a patient with GERD?

Answer 4

• Patient’s medical status
• Type and dose of medications

Regular updates are crucial for effective dental care.

Question 5

Which medications can cause gastrointestinal distress and should be used with caution in patients with GERD?

Answer 5

• ASA
• Aspirin-containing compounds
• NSAIDs
• Corticosteroids

These medications may exacerbate GERD symptoms.

Question 6

True or false: Narcotic analgesics can reduce lower esophageal sphincter (LES) pressure.

Answer 6

TRUE

This reduction increases the likelihood of gastric acid regurgitation.

Question 7

What should patients be instructed to do after regurgitation to prevent enamel dissolution?

Answer 7

• Rinse mouth
• Use a baking soda mouth rinse

This helps neutralize acid and protect dental enamel.

Question 8

What are some oral manifestations associated with ulcerative colitis?

Answer 8

• Aphthous-like lesions
• Pyostomatitis vegetans

These conditions can occur during gastrointestinal flare-ups.

Question 9

What is the prevalence range of oral manifestations in Crohn’s disease?

Answer 9

0.5% to 80.0%

Oral findings may precede intestinal disease in many patients.

Question 10

What are considered specific and pathognomonic oral findings for Crohn’s disease?

Answer 10

• Macrocheilia
• Cobblestoning of oral mucosa
• Deep linear ulcers of buccal vestibules
• Polypoid mucosal tags

These findings are indicative of Crohn’s disease.

Question 11

What should be assessed in the dental evaluation of a patient with IBD?

Answer 11

• Type of inflammatory bowel disease
• Severity of disease
• Presence of oral complications
• Medications used
• History of surgical therapy

This information is essential for effective dental management.

Question 12

What is a poor candidate for elective dental care in patients with IBD?

Answer 12

A patient with 6 or more bowel movements per day with blood, combined with fever, anemia, or a sedimentation rate higher than 30 mm/hour

Such patients should be referred for medical evaluation.

Question 13

What treatment modalities are used for oral manifestations of IBD?

Answer 13

• Topical corticosteroids
• Intralesional steroid injections
• Systemic prednisone therapy
• Sulfasalazine

These treatments aim to manage oral lesions associated with IBD.

Question 14

What should be monitored in patients receiving TNFa-blocking agents?

Answer 14

• Signs or symptoms of infection
• Fever
• Malaise
• Weight loss
• Sweats
• Cough
• Dyspnea

Close monitoring is crucial due to the risk of serious infections.

Question 15

What should be obtained prior to initiating invasive dental treatment for patients on TNFa-blocking agents?

Answer 15

CBC with differential (including platelet count)

This helps assess the risk for infection and hemostasis.

Question 16

What is the current understanding of NSAIDs on IBD activity?

Answer 16

Inconclusive

It remains unclear whether NSAIDs cause flares of IBD.

Question 17

What is recommended regarding the use of NSAIDs or COX-2 inhibitors in patients with IBD?

Answer 17

Usually not recommended due to increased cardiovascular and gastrointestinal toxicity

This is especially true for older patients.