Small-Bowel Behcet’s Disease

Abstract

Behcet’s disease (BD) is a chronic recurrent inflammatory disease involving multiple organs, characterized by recurrent oral ulcers, genital ulcers, uveitis, and skin lesions. Intestinal BD is suspected if ulcerative lesions in the gastrointestinal tract are present in patients with BD. The typical ulcer of intestinal BD is characterized by a single or a few deep round to oval ulcers with discrete margins in the ileocecal area, but all digestive organs from the mouth to the anus can be affected. Erythema, erosions, and ulcers can be observed in the small intestine. Symptoms of intestinal BD include abdominal pain, diarrhea, hematochezia, vomiting, changes in bowel habits, weight loss, fever, and abdominal mass. For the diagnosis of intestinal BD, colonoscopy, upper gastrointestinal endoscopy, capsule endoscopy, computed tomography enterography, blood test, and stool test can be performed. The differential diagnoses include Crohn’s disease, intestinal tuberculosis, drug-induced enteritis, cytomegaloviral enteritis, amoebiasis, and Salmonella enteritis. In general, the presence of bowel involvement in patients with BD is associated with a poor prognosis, and intestinal BD has a chronic recurrent disease course. Complications may include massive bleeding, fistula, perforation, and intestinal obstruction, which may need surgery. The treatment, which may include 5-aminosalicylic acid, steroids, immunomodulators, biological agents, colchicine, thalidomide, and surgery, is determined by the clinical severity of the disease.