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Apthous Ulcers: (Canker Sores)
Gluten related disease may cause recurrent apthous stomatitis.
A high rate of patients with recurrent apthous stomatitis and celiac disease respond well to treatment with a gluten-free diet. Patients with recurrent apthous stomatitis were found to have a higher rate of gluten sensitive bowel disease than the general population which supports screening these patients for celiac disease.
Assessment and Plan: Apthous Ulcers (Canker Sores)
The primary care physician should evaluate patients with recurrent apthous ulcers, multiple lesions, drainage, fever, or ulcers lasting over a prolonged period of time. Further evaluation may be needed for Herpes Simplex Virus or immune deficiency.
Avoid all dairy products.
Correct nutritional deficiencies of folic acid, B12 and iron.
Prevent viral infections with frequent hand washing and sanitizing surfaces.
Patients with recurrent apthous stomatitis were found to have a higher rate of gluten sensitive bowel disease than the general population which supports screening these patients for celiac disease. Consider eliminating gluten in the diet.
