Diseases of the Gastrointestinal Tract

In this chapter, diseases of the gastrointestinal tract that primarily affect areas other than the oral cavity are discussed. This chapter is not intended to be a complete review of all diseases affecting the gastrointestinal tract; rather, emphasis is on the medical aspects, the dentist’s role as a primary health care provider in screening for undiagnosed conditions, and the dentist’s role in monitoring patient compliance with recommended medical therapy for gastrointestinal conditions that are likely to be encountered in the general practice of dentistry. Dental health care workers are expected to recognize, diagnose, and treat oral conditions associated with gastrointestinal diseases, as well as provide dental care for afflicted individuals. To provide safe and appropriate dental care, dentists are typically concerned with the proper diagnosis of oral manifestations of gastrointestinal disorders, homeostasis, risk of infection, drug actions and interactions, the patient’s ability to withstand the stress and trauma of dental procedures, and proper medical referral (when necessary). These dental management issues are therefore discussed, where appropriate, for each gastrointestinal disorder. Both dentists and gastroenterologists have their primary focus within the alimentary canal. The common embryogenesis of the oral cavity and gastrointestinal tract is occasionally reinforced for the clinician when he or she finds heterotopic gastric mucosal cysts in the oral mucous membranes or on the tongue.1,2 However, in addition to these relatively rare anomalies, the paths of gastroenterologists and dentists cross quite frequently in clinical practice. The digestive tract is a long muscu▼ DISEASES OF THE UPPER DIGESTIVE TRACT Gastroesophageal Reflux Disease Hiatal Hernia