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Fatigue, including stress, cited among the most common triggers of oral ulcers for Behcet’s disease
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Fatigue, including stress, and diet are the two most common triggers of oral ulcer recurrences in patients with Behcet’s disease, and most patients are able to identify these triggers, according to recently published findings.
Researchers evaluated 81 patients with Behcet’s disease (BD) and a history of repeated oral ulcers (OU) seen at seven internal medicine departments at French academic hospitals. Patients completed a self-administered, structured questionnaire that included data about OU history, general OU triggers and dietary OU triggers.
Of these 81 patients, 96% met international criteria for Behcet’s disease classification. Overall, 65% of patients reported they had more than 50 OU attacks, and 53% characterized their OU attacks during the past year as “very discomforting” or “discomforting.” Moreover, 56% of patients used at least one local treatment to address OU attacks.
In response to an open-ended question about triggers, 70% of patients cited at least one general factor as a trigger of OU recurrences. Regarding the six possible OU triggers presented in a close-ended question, 62% of patients identified at least one as “surely” involved in their OU attacks. The most commonly reported triggers were stress/fatigue (30 patients; 37%) and food (26 patients; 32%).
In an open-ended question, the most commonly reported dietary triggers included nuts (22%); pineapple (14%); various citrus fruits (14%); Emmental cheese (12%); other cheeses (14%); strawberries (10%); and tomatoes (9%).
In a close-ended question, commonly reported triggers included nuts (48%); pineapple (42%); peanuts (32%); and Emmental cheese (30%). Most of these commonly reported foods are rich in histamine or histamine releasers, the researchers noted. Other frequently cited foods are known for being histamine-rich or having histamine-releasing properties.
“OU-triggering factors should be sought in patients, although we cannot affirm that preventive measures, such as psychological support, exclusion of foods, or hormonal replacement therapy, provide significant relief,” the researchers wrote. “The generated hypothesis of a pivotal role of histamine and mast cells in OU recurrences contributes to the understanding of the pathogenesis, and suggests avenues for treatment of recurrent OUs in BD.”-by Jennifer Byrne
Disclosures: The researchers report no relevant disclosures.
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