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- Title
Oral and upper gastrointestinal Crohn's disease.
- Authors
Laube, Robyn; Liu, Ken; Schifter, Mark; Yang, Jessica L.; Suen, Michael K.; Leong, Rupert W.
- Abstract
Abstract: 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.
- Subjects
CROHN'S disease diagnosis; INFLAMMATORY bowel disease treatment; INTESTINAL disease diagnosis; CROHN'S disease; IMMUNOLOGICAL adjuvants; PATIENTS
- Publication
Journal of Gastroenterology & Hepatology, 2018, Vol 33, Issue 2, p355
- ISSN
0815-9319
- Publication type
Article
- DOI
10.1111/jgh.13866