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Diagramatic representation of mucosal erosion (left), excoriation (center), and ulceration (right) Simplistic representation of the life cycle of mouth ulcers. An ulcer (/ ˈ ʌ l s ər /; from Latin ulcus, "ulcer, sore") [2] is a break in the skin or mucous membrane with loss of surface tissue and the disintegration and necrosis of epithelial tissue. [3]
A stress ulcer is a single or multiple mucosal defect usually caused by physiological (not psychological) stress which can become complicated by upper gastrointestinal bleeding. These ulcers can be caused by shock , sepsis , trauma or other conditions and are found in patients with chronic illnesses.
Burning mouth syndrome (BMS) is a burning, tingling or scalding sensation in the mouth, lasting for at least four to six months, with no underlying known dental or medical cause. [ 3 ] [ 7 ] No related signs of disease are found in the mouth. [ 3 ]
Behçet's disease is a triad of mouth ulcers, genital ulcers and anterior uveitis. [8] The main feature of Behçet's disease is aphthous-like ulceration, but this is usually more severe than seen in aphthous stomatitis without a systemic cause, and typically resembles major or herpetiforme ulceration or both.
Ulcers may act as a site for local infection and a portal of entry for oral flora that, in some instances, may cause septicaemia (especially in immunosuppressed patients). Therefore, oral mucositis can be a dose-limiting condition, disrupting a patient’s optimal cancer treatment plan and consequentially decreasing their chances of survival.
The median time interval between the onset of symptoms and the diagnosis was 6 years, with a range of 26 days to 14 years. This suggests that the symptoms of MAGIC syndrome may manifest relatively long after the initial onset of symptoms. During the course of MAGIC syndrome, the signs and symptoms of BD may typically occur before those of RP. [4]
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Symptoms prior to onset of oral ulcers are; constipation, diarrhea, abdominal gas and bloating, spastic hiccups, acid reflux and heartburn. Burning mouth syndrome appears as pre-onset symptom of ulcer manifestation. Uncotrollable belching is a later symptom associated with a systemic parasitic infection with additional symptoms. [citation needed]