Upper Gastrointestinal Tract Crohn's Disease

Crohn's disease may involve any site within the gastrointestinaltract. Usually pathology is present in the ileum and/or colon, but atypical presentationsmay occur with apparently 'isolated' involvement of the oropharynx, esophagusor gastroduodenum. If changes typical of Crohn's disease are detected in theupper gastrointestinal tract, then a careful assessment is required involvingradiographic, endoscopic and histologic studies to determine if pathology is presentin more distal intestine. In addition , microbiologic studies may be important toexclude infectious causes, especially of granulomas. If these studies are negative,prolonged follow-up may be required to establish a diagnosis of Crohn's disease.Although upper gastrointestinal involvement is increasingly recognized as a significantcause of morbidity in Crohn's disease, the treatment options are limited ,largely anecdotal and need to be the subject of detailed epidemiologic investigationand clinical trials