Cracked mouth corners are back?

[Worried mama]

Hi all. When my son was first dx, one symptom he had was cracked mouth corners. It went away quickly and hasn't been present for a very long time. About 4 months ago, he added in mtx to his medicine cocktail. He also added in folic acid at same time. About 2 days ago, I noticed the cracked mouth corners are back. Thoughts? Could it be a deficiency in folic acid due to the mtx? Does it mean disease is still very active? I will place a call to gi but sometimes I think the advice here is better . I'm hoping it's just that he needs higher dose of folic acid....

 

[my little penguin]

What time of year (season)? Was the cracked mouth last time?
Any stuffy nose on the am ?
Any seasonally /environmental allergies ??
Sicca syndrome is autoimmune and quite common with other disorders such as crohns /JSpA which can cause it
Does he use Chapstick before going to bed

 

[Worried mama]

What time of year (season)? Was the cracked mouth last time?
Any stuffy nose on the am ?
Any seasonally /environmental allergies ??
Sicca syndrome is autoimmune and quite common with other disorders such as crohns /JSpA which can cause it
Does he use Chapstick before going to bed

Well, last time, I think the cracked mouth corners were constant. He does have allergies to dust mites and cats (just sent to allergist yesterday). We went because he's constantly sneezing and his eyes are constantly irritated and itchy. He's never produced tears but eye dr has checked and few years ago said his eyes were not 'dry' despite the no tears. If he's really crying, a few tears might escape...he is not allergic to any outside pollen, trees, weeds, etc. he does not use Chapstick.

 

[Clash]

Cracked corners of the mouth can be a symptom of vitamin deficiencies like iron, b12 etc.

My son has had this when his b12 was low.

Might be a good idea to have them run a vitamin panel.

 

[my little penguin]

Was it an opthamolgist or optometrist ?
They had to measure the thickness of something on Ds - assume his lower lid which proved he had sjogrens
Lemon drops or sour candy can increase mouth saliva and fix cracked mouth from sicca syndrome
If his allergies are acting up nose spray nasonex Dymista etc ...
Can keep his nose clear and stop mouth breathing /cracked lips

 

[Worried mama]

Was it an opthamolgist or optometrist ?
They had to measure the thickness of something on Ds - assume his lower lid which proved he had sjogrens
Lemon drops or sour candy can increase mouth saliva and fix cracked mouth from sicca syndrome
If his allergies are acting up nose spray nasonex Dymista etc ...
Can keep his nose clear and stop mouth breathing /cracked lips

He saw the ophthalmologist and also optometrist. I think it was optometrist tho that measured eye dryness...they did some test, it was quick. But for his constant eye itchiness we also took him to chop ophthalmology and they checked for all Crohns related eye issues and did full exam and all was good...determined to be allergies, which is why we then saw allergist for full testing. Ugh...Drs, Drs, Drs. Allergist did exam and also said, yup allergies. Just got a nose spray at allergist and will use it tonight. His mouth isn't dry tho...he's got plenty of saliva so not sure about sicca...I'm thinking more likely folic acid is low due to the mtx?

 

[Worried mama]

Cracked corners of the mouth can be a symptom of vitamin deficiencies like iron, b12 etc.

My son has had this when his b12 was low.

Might be a good idea to have them run a vitamin panel.

Thanks. Can low folic acid also be the culprit? Just placed call to our GI and asked for vitamin levels to be tested at next infusion which is not til mid August...but I suppose we can wait, or I'll see if gi thinks we need to do something sooner. Have I mentioned lately that I really hate this disease and everything that goes with it.

 

[Clash]

It's several different ones. I think I remember the GI said several B vitamins and iron but not if B9 (folic acid) was included.

 

[Worried mama]

It's several different ones. I think I remember the GI said several B vitamins and iron but not if B9 (folic acid) was included.

Thanks. It's hard to imagine he's deficient. He takes multi vit, vit D supp, drinks one boost a day, gets overnight feedings (3 1/2 peptamin prebio), takes folic acid supp...gosh, you'd think that should be enough.

 

[Clash]

Yeah definitely. And it could totally be something else. Our GI thought C's was due to his iron deficiency anemia but it didn't go away until his B12 got in the normal range.

Maybe not a direct correlation with him but my daughter(non IBD) also had them. Her B12 was extremely low. Once it improved the cracks went away. So for them I do think it had something to do with low B12

 

[Trysha]

It was a dental surgeon who told me I had Vit A deficiency so I bought a multivitamin capsule with Vit A in it and the dry mouth corners and soreness cleared away quite nicely.
Feel better
Trysha

 

[Layla]

I had cracked corners of my mouth when I was on MTX and it was definitely due to low folic acid. As soon as I increased the dose they went away. I asked my specialist and she said it's a vitamin deficiency and because of the mtx most likely folic acid.

 

[Worried mama]

Thank you everybody. Our GI called back and said he would test zinc levels, but he didn't mention anything else (they left a voice mail so I didn't get a chance to follow up yet)...but I think they should also test the various vitamin levels and folic acid levels...

 

[Maya142]

My daughter had that problem a few years ago and our GI tested Zinc levels too. They were in the normal range (she was also on overnight tube feeds at the time) and somehow it just resolved by itself. We used Vaseline on her mouth because it was painful.

 

[CrohnsKidMom]

I have had this problem myself off and on, and my son with crohns has had it occasionally too. I read somewhere that it could be related to a deficiency in zinc, so I started taking Zinc supplements. For healing, the best thing I have found (and I've tried them all), is to just dab a little olive oil on the cracks as many times a day as you think of it. Also be careful not to reopen the cracks once they start to heal. I'm not sure if it was the zinc or the olive oil, or maybe the combo, but it has worked well for both me and my son.