Oral and upper gastrointestinal Crohn’s disease.
J Gastroenterol Hepatol. 2017 Jul 14;:
Authors: Laube R, Liu K, Schifter M, Yang JL, Suen MK, Leong RW
Crohn’s disease is a heterogeneous, inflammatory condition that can affect any location of the gastrointestinal tract. Proximal gastrointestinal involvement occurs in 0.5-16% of patients, and it is usually diagnosed after recognition of intestinal disease. Symptoms are often mild and non-specific, however upper gastrointestinal disease predicts a more severe Crohn’s phenotype with a greater frequency of complications such as obstruction and perforation. Gastroscopy and biopsy is the most sensitive diagnostic investigation. There is a paucity of data examining the treatment of this condition. Management principles are similar to those for intestinal disease, commencing with topical therapy where appropriate, progressing to systemic therapy such as glucocorticoids, 5-aminosalicylic acid, immunomodulators and biologics. Acid suppression therapy has symptomatic but no anti-inflammatory benefit for gastroduodenal and esophageal involvement. Surgical intervention with bypass, strictureplasty or, less frequently, endoscopic balloon dilation, may be required for complications or failed medical therapy.
PMID: 28708248 [PubMed – as supplied by publisher]