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Gastroduodenitis associated with ulcerative colitis

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Abstract

Background

Ulcerative colitis (UC) is regarded as confined to the colorectum; however, there are several case reports showing upper gastrointestinal involvement. The aim of this study was to examine the prevalence and characteristics of gastroduodenitis associated with UC (GDUC).

Methods

Esophagogastroduodenoscopy with biopsies was prospectively performed on 250 UC patients (134 men, 116 women; mean age, 42 years; 162 with colectomy, 163 with pancolitis). Criteria for GDUC were created on the basis of endoscopic and histological comparisons with non-UC controls, and the prevalence and characteristics were statistically analyzed.

Results

GDUC was defined endoscopically as friable mucosa (erosive or ulcerative mucosa with contact or spontaneous bleeding), granular mucosa (multiple white spots almost without a red halo), or, conditionally, multiple aphthae (multiple white spots surrounded by a red halo, clinically excluding other disorders such as Crohn’s disease). The prevalence of GDUC was 19/250 (7.6%). The clinical characteristics included more extensive colitis, lower dose of prednisolone, higher prevalence of pouchitis, and longer postoperative period. In our population, the presence of pancolitis and a lower dose of prednisolone were significant risk factors for developing GDUC in multivariate analysis.

Conclusions

The high prevalence of GDUC suggests that the gut inflammatory reaction in UC may not be restricted to the large intestine. Administered steroids might conceal GDUC, and more aggressive UC such as active pancolitis may be related to the development of GDUC.

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Authors and Affiliations

  1. Department of Endoscopy Center, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Japan

    Kazutoshi Hori

  2. Division of Upper Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan

    Kazutoshi Hori, Toshihiko Tomita & Hiroto Miwa

  3. Department of Surgery, Hyogo College of Medicine, Nishinomiya, Japan

    Hiroki Ikeuchi, Hiroki Nakano & Motoi Uchino

  4. Division of Lower Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan

    Yoshio Ohda, Nobuyuki Hida & Takayuki Matsumoto

  5. Department of Clinical Nutrition and Health Science, Hyogo College of Medicine, Nishinomiya, Japan

    Yoshihiro Fukuda

Authors
  1. Kazutoshi Hori
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  2. Hiroki Ikeuchi
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  3. Hiroki Nakano
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  4. Motoi Uchino
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  5. Toshihiko Tomita
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  6. Yoshio Ohda
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  7. Nobuyuki Hida
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  9. Yoshihiro Fukuda
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  10. Hiroto Miwa
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Hori, K., Ikeuchi, H., Nakano, H. et al. Gastroduodenitis associated with ulcerative colitis. J Gastroenterol 43, 193–201 (2008). https://doi.org/10.1007/s00535-007-2143-8

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  • DOI: https://doi.org/10.1007/s00535-007-2143-8

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