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Dietary and Nondietary Triggers of Oral Ulcer Recurrences in Behçet's Disease
Author(s) -
Volle Geoffroy,
Fraison JeanBaptiste,
Gobert Delphine,
Goulenok Tiphaine,
Dhote Robin,
Fain Olivier,
GonzalezChiappe Solange,
Lhote François,
Papo Thomas,
Thuillier Aurélie,
Rivière Sophie,
Mahr Alfred
Publication year - 2017
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.23155
Subject(s) - medicine , behcet's disease , disease , surgery , pediatrics
Objective The nature and impact of food and other external triggers in recurrences of Behçet's disease (BD)‐related oral ulcers (OUs) remain unknown. This survey investigated dietary and nondietary triggers of BD‐related OU recurrences. Methods Patients with BD who were followed in 7 French hospital departments completed a self‐administered patient questionnaire. General and specific dietary triggering factors were sought in open questions. The questionnaire also included closed questions, notably to evaluate the effect of 6 general triggering situations and 24 selected foods. The results were expressed as number (percentage) of positive responses. Results Among the 101 questionnaires distributed, 81 were usable. Among the 81 patients, 96% fulfilled the International Criteria for Behçet's Disease classification criteria, and 53% qualified their OU recurrences during the previous 12 months as very discomforting or discomforting. For the 6 general situations suggested, 50 patients (62%) declared ≥1 as a “sure” trigger of OU recurrences. In both open and closed questions, the most frequent triggers were fatigue/stress (37–47% of patients) and food (32–35%). Among the 24 suggested foods, nuts (48%), pineapple (42%), peanuts (32%), Emmental cheese (30%), almonds (23%), lemons (22%), and other cheeses (21%) were the most frequently reported. The corresponding open question gave consistent findings but with lower frequencies. Conclusion Most patients can identify triggers of recurring BD‐related OUs, with fatigue/stress and food representing the most frequent triggers. The management of OU must consider such external factors. The histamine‐rich or ‐liberating properties of the commonly cited OU‐triggering foods suggest a hyperreactivity mechanism.