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Gluten Intolerance Linked to Canker Sores

A canker sore is a small painful ulcer in the lining of the mouth. It can also occur in the GI tract. Canker sores are pretty common and when they are found repeatedly only in the mouth, the condition is called Recurrent Aphthous Stomatitis (RAS).
These canker sores can be associated with conditions that affect the GI tract, immune defects and syndromes that are inflammatory. They are not infectious or contagious in any way. However; up to 20% of patients with RAS are deficient in iron, vitamin B and folic acid. Another 3% have malabsorption or GI disorders. The detergent sodium lauryl sulphate found in toothpastes may aggravate them. And NSAIDs and other drugs can cause them.
Researchers wanted to find out how many RAS patients had gluten sensitive enteropathy and assess whether or not a gluten free diet could improve the canker sores.
They found 247 patients with RAS and screened them with the IgA anti-endomysial antibody (EMA) test along with serum IgA and IgA anti tissue transglutaminase. Seven patients with at least one positive test then had duodenal biopsies and all were found to have gluten sensitive enteropathy. This explained why these 7 patients were not successfully treated with the usual anti-canker sore medications (topical corticosteroids, tetracycline, colchicines). Over the next six months, 4 of the patients that went on a strict gluten free diet improved greatly.
Researchers concluded that in patients with RAS, it’s appropriate to test for celiac disease, especially in those who don’t improve from a traditional prescriptions for RAS.
Source: BMC Gastroenterol 2009; 9: 44. Gluten sensitivity enteropathy in patients with recurrent aphthous stomatitis.

Gluten Free Society’s Stance

It’s a little surprising that the researchers found that all 7 patients had a positive biopsy for gluten sensitivity enteropathy. Often this does not happen. A biopsy only selects a small amount of tissue, almost at random, and that tissue sample may not be reflective of what’s occurring in the intestinal tract. Everyone with gluten sensitivity won’t have a positive biopsy, and that could explain why the condition may not be identified.
The researchers made a great correlation in this study, but there are still too many people that are suffering from undiagnosed gluten sensitivity enteropathy. The problem is finding them!
Dr. Kenneth Fine’s research has found that the most common symptom of gluten sensitivity is the canker sore. So the question becomes – Do you have chronic recurring canker sores and don’t know why? You may be gluten sensitive. Genetic testing might be a good idea.  

12 Responses

  1. I have been getting a puss filled sore on my gum for over three months now, every 2-3 days it fills up. I also get a canker type sore on the inside of my upper lip once in awhile, and I was wondering if this could be gluten related. I have gluten intolerance, and am sure that once in awhile when eating away from home I maybe getting gluten in my food without realizing it.

  2. I always thought my mouth ulcers came from too much citrus, since the worst were in December (fruit fr Florida), and in July (tomatoes). Did not have them when I was pregnant, and since now I stick to a gluten/wheat sensitive diet, I hardly ever have one. I read a long, long time ago that the condition of our mouth reflects the condition of our stomach!

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  4. For 40 years I sufferred from canker sores, with one or two active nearly all the time. Retracted gums entered the picture in my late teens. Dentists blamed a hard toothbrush and later the toothpaste, but even today not one of them makes the connection to gluten, not even for the enormous salivary gland stone.
    Now, 40 months gluten free I have had canker sores about once a yar after some trauma in the mouth, so that was a bonus well worth proclaiming.

    1. Thanks so much! It means a lot as DR. Osborne works very hard to educate and assist people heal daily in his clinical practice.

  5. I have reoccurring canker sores constantly. Right now I have about 5 in my mouth. I’ve had just about every blood test out there. Even an endoscopy and colonoscopy and nobody has found anything. Doctors and people around me have convinced me I’m crazy! I’m now thinking after reading this that I should cut out gluten completely for a month or so and see if the sores come back. I’m desperate! They are so painful!! If anyone has any advice PLEASE let me know! It is comforting to know that there is people out there that know my pain!

  6. Thank you for this article. My 6 yr old has developed these within the last year. At first drs stated due to stress, however they don’t go away even when they have given her Acylclovir (sp?).. She has many sensitivities to foods and has lots of stomach pain after eating. I’m going to mention this article to her allergist when we see them next!

  7. Hi for many years now I get canker soars in my mouth and they will last fir months I have seen many doctors ,and an allergies abd a dermatologist but not much help.lately I did go see an osteopathic doctor which did a blood food allergy test and find out that I have allergies to diary,yogurt,honey, beans and banana .but before visiting the above tge doctor I had eliminated gluten from my diet but not white rice and steel cut oats .after four months I had only two weeks without canker soars ,but soon after the blisters are back but they are less painful and I still have blisters in my mouth . My recent visit to doctor he recommended I take food allergy injection under tge skin which will help he says that can be repeated every two months.buti told him I will think about it. I am happy to find dr. Osbornon tge you tube abd I got tge book no grain no pain today and trying to read it fast get to know more thank you for all your efforts. Anna

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