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Oral and upper gastrointestinal Crohn's disease
Author(s) -
Laube Robyn,
Liu Ken,
Schifter Mark,
Yang Jessica L,
Suen Michael K,
Leong Rupert W
Publication year - 2018
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13866
Subject(s) - medicine , crohn's disease , disease , perforation , gastroenterology , gastrointestinal tract , balloon dilation , medical therapy , inflammatory bowel disease , surgery , punching , materials science , metallurgy , balloon
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 nonspecific; 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.