EUROMEDICA  Hanover 23-24  Mai 2011	Advanced methods of diagnosis, treatment and prophylactics
	European Academy of Natural Sciences, Hanover European Scientific Society, Hanover

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Many clinicians are concerned about possible relationship between the esophagus, stomach, and duodenal ulcer diseases and the oral cavity.

Aim of this study is to research the clinical condition of the oral mucosa in patients with diseases such as gastroesophageal reflux disease (GERD), chronic gastritis, peptic ulcer, duodenal ulcer, dysfunction of the bile duct, chronic pancreatitis.

Inspection of the oral cavity was performed in 205 patients who sought help from a gastroenterologist and a dentist. Age and sex of the patients were not limited. From among all the surveyed men were 45,5%, women - 54,5%. Biting the cheeks and tongue while eating was observed in patients with erosive and ulcerative lesions of the esophagus, as well as in patients with diseases of the gallbladder and pancreas. Burning and pain in the tongue appearing in patients of all these groups. Abundant patches on the tongue in patients was periodically frequent, especially in patients with diseases of the gallbladder and pancreas. The emergence of aphthous ulcers in the oral mucosa periodically observed in 21,4% patients. From the revealed drought without damaging of epithelium integrity of the red portion area seen in 17,4% patients. Sometimes (1.6%) there were flakes, cracks in the red portion, which is characteristic dry form of exfoliative heylitis. Angularly cheilitis was observed in 6,6% cases. Swelling of the oral mucosa was observed in patients in all groups surveyed (30,8% of cases). This feature occurred in 100% cases in patients with the most severe form of GERD. Biting cheek mucosa was found in 12,8% patients. Cyanosis of the oral mucosa of patients was determined in 11,5% cases. Chronic recurrent aphthous stomatitis was found in 9% patients. The exception was the group of patients with noneroziv reflux disease (NERD), where chronic recurrent aphthous stomatitis has not been found. Hyperkeratotic thickening of the epithelium of the mucous membrane of cheeks in the form of plaques was observed in 6,9% cases. However, this feature was absent in patients with NERD. Lichen planus was diagnosed in 7,5% patients. Process of increasing keratinization whisker papillae and papillary apparatus of the tongue changes was in 14% cases. Size increasing of patients’s filiform papillae was always observed with an ample coating on the tongue.

Conclusions.

1. Clinical manifestations in the oral mucosa in diseases of the esofagogastroduodenal and holetsistopankreatic zones are characterized by symptoms such as: drought, hypersalivation, atrophy of the papillary apparatus, the presence of abundant plaque marks of teeth on the mucous membrane of cheeks and on the lateral surface of the tongue, the trauma of the oral mucosa as a result of biting, the centers of desquamation, the phenomenon of hyperkeratosis, the presence of papules and aphthous ulcers.
2. Changes in the oral mucosa have a tendency to increase the diversity and frequency of occurrence in correlation with the severity of pathology of the digestive system.