If you have ulcerative colitis (UC), mouth problems may start before more typical symptoms like cramps and diarrhea. Some mouth sores are mild, while others can affect your ability to talk or eat.

Diarrhea and stomach pain are among the most well-known UC symptoms because UC primarily affects the colon and rectum. These symptoms stem from inflammation and sores called ulcers in the intestines.

Sores outside these areas are known as extraintestinal manifestations. Although it’s not very common, UC may cause mouth sores.

Read on to learn about the common mouth problems that UC or its treatment can cause.

UC itself doesn’t cause inflammation in the mouth, but conditions that are secondary to UC may cause mouth problems.

Mouth sores may appear in your mouth for several reasons if you have UC, including:

  • taking some UC medications that cause dry mouth and swelling in the mucous membranes
  • having vitamin and mineral deficiencies, such as vitamin B and iron

UC and its treatments may cause several mouth problems, ranging from mild to severe.

Canker sores (aphthous stomatitis) are painful white or yellow spots that form inside the mouth around the gums, lips, or tongue.

Research suggests UC and other inflammatory bowel diseases (IBDs) are associated with canker sores. For instance, you may experience canker sores during a UC flare-up, and they typically heal once you treat the flare.

In addition, pyodermatitis-pyostomatitis vegetans is a rare condition that mainly affects people with UC. Symptoms may include a rash in skin folds like the armpits and groin. You may also experience pus-filled sores inside the mouth and throat.

A dry mouth can be caused by UC.

However, some medications used to treat UC, such as corticosteroids, antidiarrheals, and anti-inflammatories, may also cause dry mouth as a side effect. These medications may include:

  • diphenoxylate and atropine (Lomotil)
  • loperamide (Diamode)
  • mesalamine
  • metronidazole (Flagyl)
  • propantheline

Speak with a healthcare professional if you experience dry mouth and are taking any of these medications for UC. They could modify your treatment plan by recommending an alternative drug or adjusting the dosage.

Some people with UC report a metallic or acidic taste in their mouth.

This symptom is more common in people with pancolitis, a severe inflammatory disease that affects the entire colon and is usually caused by UC.

Taste changes may stem from a B12 vitamin deficiency. Experiencing a metallic taste can be a side effect of the drugs sulfasalazine, azathioprine, and metronidazole (Flagyl).

Bad breath (halitosis) often occurs if your oral hygiene habits lapse. In UC, bad breath may be due to dry mouth.

Saliva washes away dead cells and bacteria in the mouth. When the mouth is dry, those cells build up, leaving an unpleasant breath aroma.

Some people with UC who experience bad breath may have an increased level of sulfate-reducing bacteria in the colon. This leads to higher amounts of the gas hydrogen sulfide, causing bad breath.

Glossitis is inflammation of the tongue. It’s relatively common in UC. When your tongue is swollen, it may be harder to eat and talk.

The condition is usually caused by folate, vitamin B12, or zinc deficiency, which is relatively common in people with UC.

Angular cheilitis causes swollen red patches to form in the corners and outer part of your lips. It sometimes affects people with UC.

The cause in people with UC is often a vitamin B12 or iron deficiency. Long-term treatment with corticosteroid drugs can also result in this symptom.

The first step to relieving UC mouth sores and other mouth problems is reducing inflammation in your GI tract and implementing a treatment plan to manage your UC.

Treatment for UC may include medications that calm the overactive immune system response that causes inflammation and sores. These may include:

  • aminosalicylates (5-ASAs)
  • corticosteroids
  • immunomodulators
  • biologics

Some other ways to help prevent mouth sores include:

  • rinsing regularly with an antiseptic mouthwash
  • eating a well-balanced diet
  • taking a multivitamin or mineral supplement
  • trying stress-relieving activities, such as yoga, exercising, and listening to music

Talk with a doctor if you think a medication you take for UC could be causing symptoms. They may recommend complementary treatments that are less likely to cause mouth sores or suggest other ways to manage this side effect.

Besides UC and medications, some causes of oral problems like mouth sores may include:

  • mouth trauma
  • genetics
  • lifestyle habits, such as smoking
  • stress
  • viral or bacterial infections, such as HIV
  • underlying health conditions, such as Behçet’s disease, erythema multiforme, and celiac disease

While having issues in your mouth doesn’t necessarily mean it’s something serious, it’s worth having it checked out. In some cases, it can also be a sign of cancer.

Speak with a healthcare professional if:

  • your symptoms don’t away after 2 weeks
  • you have any new symptoms in your mouth or other parts of your GI tract
  • your mouth problems affect your ability to eat or talk

A doctor could provide a proper diagnosis and develop an appropriate treatment plan.

Can ulcerative colitis affect your mouth?

Yes, ulcerative colitis is associated with oral symptoms, such as canker sores, bad breath, and a change in taste.

What are the oral symptoms of IBD?

Some oral symptoms of IBD include burning mouth syndrome, canker sores, dry mouth, and bad breath, among others.

What are the sneaky signs of ulcerative colitis?

Although less common, symptoms of ulcerative colitis may affect your mouth. For instance, canker sores may be an early indicator of an ulcerative colitis flare-up.

Mouth problems are not the most common symptom of UC, but they sometimes appear before more common symptoms like diarrhea and stomach cramps.

Watch for sores, swelling, pain, and changes in taste, and report them to a doctor. Changing your treatment or adding a nutritional supplement may help relieve these issues.