Correlation between Oral Mucosal Changes and Intestinal Histopathology in Inflammatory Bowel Disease Patients: Impact of Clinical Activity and Psychosocial Stress

IBD (inflammatory bowel disease), which is a combination of ulcerative colitis and Crohn's disease, is a chronic inflammatory disease that has substantial effects outside the intestines. Since changes in the oral mucosa correspond to the clinical manifestation of intestinal inflammation, changes in the oral mucosa of patients with IBD are common. The aim of the study was to establish how the clinical and psychosocial level of stress interacts with the clinical disease level of activity, as well as the variation in the intestinal and oral mucosal histological severity of the IBD patients. 177 participants with IBD were recruited (63 with Crohn disease, and 44 with ulcerative colitis). All patient data were collected between June 2024 and June 2025 at different hospitals in Iraq. Clinical disease activity was measured using the Harvey-Bradshaw Index (in Crohn victims) and the Mayo Score (in ulcerative colitis victims). The mucosal changes were identified and categorized with the help of oral examination and were classified in terms of the specific lesion. Lintel histology was assessed under three variables, namely mild, moderate, and severe inflammation. The psychosocial levels of stress were measured with the help of the Perceived Stress Scale (PSS). There was also a considerable difference between the presence of oral lesions and the current clinical disease (p<0.001) as well as moderate to severe intestinal inflammation (p=0.003). The oral lesions acquired by the patient were dose-dependent, and more oral lesions would be acquired when the patient was under a lot of stress (73.1%). A satisfactory clinical outcome to assess the condition of the disease can be the lesions in the IBD mucosa of the mouth that can be a powerful indicator of the severity of the intestinal histology and clinical activity. Psychosocial stress, which is a complication of the oral symptoms, also indicates the degree of whole-person care which influences the psychological well-being.