<<Disclaimer: Verify this information before applying it to your situation.>> I posted an inquiry about canker sores to this list. Quite a number of you responded to the effect that canker sores decreased or disappeared after going on a g-f diet. Whether this is directly related to celiac or simply to better nutrition once on the g-f diet isn't clear to me. This is a slightly edited compilation of the comments: I have had consistent canker sores, which doctors and dentists have "waved away" as temporary for the past 15 years. I have been recently diagnosed with Celiac disease after going 1 1/2 years with continuous diarrhea. Needless to say, quite a bit of weight was lost and anaemia set in. Now, I find that, without Gluten, I have not had a single canker! >>I used to get canker sores all the time before I started the gf diet about 9 >>years ago. I can't remember having any since then. I haven't really thought >>to make the connection but it sure sounds like you may have something here. >> Please post a summary of your responses. When I read your post, I remembered reading an article about the relationship of canker sores to toothpaste. As I couldn't remember the toothpaste which was recommended for canker sore sufferers, I didn't reply to your post. Just this evening I ran across some info; most toothpastes contain SLS(sodium lauryl sulphate). When sufferers used a toothpaste without that, they showed a 70% reduction in outbreak. The toothpaste is Natural Rembrandt Whitening Toothpaste. There are several brands of Rembrandt toothpaste, but this one is SLS-free. I also get canker sores when I eat gluten. When I'm gf I might get a >>few but not as bad. One remedy is lysine. I don't know why it helps >>since it is supposed to only work on cold sores (they are a form of >>herpes virus which can't live in the presence of lysine). I take a >>couple of grams of lysine a day and the sores are minimal. Also, avoid >>dairy, chocolate and sugar as much as possible during outbreaks. I >>found a product called Aloe vera detox by Naturade it makes a big >>difference in the healing of canker sores for me. Assuming that the >>canker sores are a reflection of sores in my intestine, the healing of >>the intestine also heals my mouth sores. >My experience confirms link between gluten ingestion and canker sores. > Pre-GF diet I had frequent bouts of canker sores. Since going GF about 6 >months ago, no canker sores, except when I went off the diet for about 1 week >preparatory to biopsy. After 5 days eating wheat again, I got the most >ferocious case of canker sores I ever had. By the way, Zylactin, which is an >over-the-counter goo that forms a skin over the sores, is the only thing I've >found which brings relief from discomfort and speeds healing. I should add, >my biopsy was negative. Nevertheless, I remain GF due to bloating, diarrhea >and canker sores whenever I eat gluten. Caprylic acid (to control candida) >also helps me. >> >>While I do not have Celiac Disease, my 5 year old does, I do suffer from >>canker sores. At one point they were as large as dimes. A dermatologist >>recommended Viadent oral rinse. As soon as I read the post, I ran to the >>medicine cabinet, grabbed the bottle, and called the Colgate company. They >>assured me that it is gluten free. I use it a couple times a day as soon as >>I feel the sensation of a sore coming on. I rarely get sores now >> >>As a child growing up I had canker sores, cold sores, fever >>blisters, etc. so often that every picture of me in school >>shows me with blisters on my lips. I was diagnosed 5 years >>ago with celiac and rarely ever have a blister now. I think >>there is a correlation between the two (at least for me). >> I dont know about all, but I used to get canker sores all the time >before dx. Since dx, 5 yrs ago, I've only had them a couple times, and each >time could trace them to accidental ingestion of gluten. Coincidence?? I >dont think so. I also know of a couple other people in our group with the >same reaction. it also seems to occur if you are using the wrong lipstick or >gloss. __________________________________________ From: Can A GLUTEN-FREE DIET HELP? How? by Lloyd Rosenvold, M.D., [Keats Publishing, 27 Pine Street (Box 876) New Canaan, CT 06840-0876, 1992, ISBN 0-87983-538-9] Pages 123-124. Aphthous Stomatitis -- ("Canker" Sores in the Mouth) We have known for many years that "canker" sores in the mouth were sometimes associated with vitamin B deficiency. So also with food allergies. For example, I have known a person who developed allergy to soy products and when he would eat them tiny painful ulcers would develop along the sides of his tongue. Often at the same time circumscribed painful areas would develop in his stomach. these we believed were similar tiny ulcers such as seen on the tongue. When soy was discontinued the mouth ulcers would heal and when the pain there went away, so also did the pained areas in the stomach, probably indication that the gastric ulcers also healed. Now we learn from several medical journal reports that these mouth ulcers can be associated with CD [Celiac Disease]. One report (in Gut 21:223-226, 1980) found two cases of the mouth ulcers in 50 patients with CD. In another report (in Digestive Diseases & Sciences 26[8]:737-740,1981) out of 20 patients with recurrent aphthous ulcers, 25% showed favorable responses to a withdrawal of gluten from the diet. In this study none had demonstrable intestinal lesions. Either they did not have CD, or else the disease was in such early stages that the intestinal lesions could not be demonstrated on biopsy. (Compare with the report from Holland that follows.) In a report from Holland (Netherlands J. of Med. 31:256-262,1987), 168 patients with CD were studied, of whom 28% complained of mouth ulcerations from time to time. Just what kind of cytotoxin or neurotoxin is produced in the intestinal lesions that can travel via the bloodstream and produce ulcers in the mouth we do not know. We must conclude from this study that any person with recurrent aphthous stomatitis ulcers should certainly receive the benefit of studies to check on CD and perhaps a trial of a GF diet for several months. _______________________________ I hadnt really thought about that before, but now I realize that since i started my GF diet in January, I havnt had a single canker sore! i used to have them semi-frequently (once a month or so), so i guess these may be influenced by gluten in the diet. ________________________________________ "Encyclopedia of Natural Medicine" by Michael Murray, ND and Joseph Pizzorno, ND, Prima Publishing, 1995, ISBN 1-55958-092-5 (hard cover); ISBN 1-55958-091-7 (pbk.) (they also wrote "A Textbook of Natural Medicine") From: Chapter 56, pages 425-427: MOUTH ULCERS * Single or clustered shallow painful ulcers found anywhere in the oral cavity * Lesions are from 1 to 15 mm in diameter, have fairly even bordered, are surrounded by a reddened border and are often covered by a white membrane. * Lesions usually resolve in 7 to 21 days, but are recurrent in many people. General Considerations --------- Recurrent canker sores, mouth ulcers of aphthous stomatitis is an extremely common condition, estimated to affect 20 percent of the population. the cause of recurrent canker sores, based on studies of initiating factors, appears to be related to food sensitivities, stress and nutritional deficiency. Therapy ------ Food and environmental allergens The oral cavity is, obviously, the first site of contact for ingested, and many inhaled allergens.. The association of recurrent mouth ulcers with increased serum antibodies to food antigens suggests an allergic reation is involved. Furthermore, allergic antibody-bearing lymphocytes are significantly increased in mouth ulcers and mast cells are increased in tissue sections from prodromal stages of recurrent ulcers. Mast cell release of histamine and other inflamatory particles play an imporant role in the production of a mouth ulcer. A diet eliminating allergens has been shown to have good theraputic results. Stress is often a precipitating factor in recurrent mouth ulcers, suggesting a breakdown in normal host protective factors. Stress greatly increases the development of allergies.. Nutritional Deficiency -- A study of 330 patients with recurrent mouth ulcers found that 14.2% were deficient in iron, folate or vitamin B12, or a combination of these nutrients. When these patients' deficiencies were corrected by supplementation, the majority had complete remission. Other studies have shown similar deficiency rates for the same nutrients and equally good response to supplementation. Zinc supplementation has also been shown to be effective in some patients (particularly those with low serum zinc levels.) Gluten Sensitivity ----- The incidence of recurrent mouth ulcers is increased in patients with coeliac disease, a condition caused by sensitivity to wheat gluten. Biopsy of the small intestine in 33 patients with recurrent mouth ulcers showed eight to have the intestinal damage of coeliac disease, along with signs of allergic reactions to food antigens. The remaining patients also exhibited these types of signs, but to a lesser degree. An underlying gluten sensitivity would also contribute to nutritional deficiencies. Withdrawing gluten from the diet results in complete remission of recurrent mouth ulcers in patients with coeliac disease and usually some improvement in the rest of the patients. Flavonoids --- Several flavonoids are known to inhibit mast cell degranulation, basophil histamine release and the formation of other mediators of inflammation. The anti-allergy drug di-sodium cromogylcate, a compound very similar in structure and function to the flavonoids, has been shown to be effective in the treatment of recurrent mouth ulcers, resulting in an increase in the number of ulcer-free days and in mild symptomatic relief. Several flavonoids, including quercetin, acacetin, apigenin, chrysin and phloretin have also shown anti-allergy effects similar to disodium cromoglycate. Treatment --- The data described above suggests that no single factor is solely responsible for the initiation of mouth ulcers in any specific individual. The therapeutic approach to mouth ulcers is similar to that in other diseases with an allergy basis. Foremost is the recognition and control of allergens, particularly gluten. In addition, nutrient deficiencies need to be corrected and anti-inflamatory nutrients prescribed. Diet--- The diet should be low in animal products, high in complex carbohydrates and free of known allergens and all gluten sources (wheat, oats and barley). Supplements--- *Vitamin c, 1 g per day *Zinc (picolinate), 25 mg per day *Multiple vitamin and mineral, one to five times the recommended dietary allowance *Mixed Bioflavonoids, 1 g per day I looked up mouth ulcers in the Merck Manual (16th edition). It said "Etiology is unknown, but several factors point toward a localized immune reaction. Deficiencies of iron, vitamin B12 and folic acid increase susceptibility. Stress and local trauma are usually the predominant precipitating factors." _________________________________________ >>My husband constantly is plagued with canker sores throughout his mouth. >>He has tried Zofirax (sp) but to little avail. Vitamin deficiencies have indeed been linked to apthous ulcers (the proper name for canker sores). The reason Zovirax didn't work is that Zovirax is specifically for the herpes virus (i.e. cold sores, shingles, chicken pox, et. alia) Frequently apthous ulcers are misdiagnosed by well-meaning doctors as herpes virus, even though the two affect different tissues in the mouth. One only affects keratinized tissue, i.e. the gums (the tissue is harder than regular tissue), the other only soft tissue (i.e. lips and tongue). For immediate relief of the pain of canker sores, use something along the lines of Chloraseptic spray, or Sucrets Extra Strength. Both have anaesthetic properties that help reduce the pain. Then go see your DENTIST. There is TREATMENT for canker sores; it is similar to chemical cauterization and it is a little painful; however, the pain is temporary and alleviated with ibuprofen, etc., and Guess What! The sore heals in 24 hours afterwards. My recent post concerning canker sores and celiac brought a number of responses. Most who commented said that their Behcet-caused canker sores had abated after being on a GF diet. Some, however confused canker sores (inside the mouth) with cold sores on the lips and outside the mouth. I have therefore modified my data sheet to clarify the difference. I also remember hearing that sodium laurel sulfate, an ingredient common to toothpaste can bring on these eruptions. Rembrandt natural toothpaste is one of the few I have found that are sodium laurel sulfate-free. Before diagnosis I suffered with very bad canker sores. My consultant said that they were very much an indication of CD. I still get an occasional sore but I think this is more due to trauma that diet. I was recommended many years ago, by a dentist, a paste called Adcortyl in Orabase. Don't know if you can get it in the US, but in England it is on prescription only. It is really very good. I can't say how true it is, but I used to get canker sores a lot. I have not gotten one since going gluten free. Coincidence? I don't know.