Skip to main content
SpringerLink
Log in

Esophageal, gastric, and duodenal manifestations of IBD and the role of upper endoscopy in IBD diagnosis

  • Published:
Current Gastroenterology Reports Aims and scope Submit manuscript

Abstract

Upper gastrointestinal (GI) tract inflammation in inflammatory bowel disease has become increasingly recognized, even in the absence of specific localizing symptoms, as patients more frequently undergo upper endoscopy. Although the recent Montreal classification system allowed classification of upper GI involvement in Crohn’s disease (CD), independent of other locations, a consensus regarding the definition of what qualifies as significant “involvement” is still lacking. Reported incidence data vary considerably depending on the definitions used and the selected target population. Pediatric data suggest that upper endoscopy is useful in differentiating CD from ulcerative colitis, when inflammation is otherwise predominantly confined to the colon; however, this question has yet to be studied in adults. Infliximab therapy for upper GI-CD seems as effective as that seen for more distal GI inflammation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Rutgeerts P, Onette E, Vantrappen G, et al.: Crohn’s disease of the stomach and duodenum: a clinical study with emphasis on the value of endoscopy and endoscopic biopsies. Endoscopy 1980, 12:288–294.

    Article  PubMed  CAS  Google Scholar 

  2. Nugent FW, Roy MA: Duodenal Crohn’s disease: an analysis of 89 cases. Am J Gastroenterol 1989, 84:249–254.

    PubMed  CAS  Google Scholar 

  3. Nugent FW, Richmond M, Park SK: Crohn’s disease of the duodenum. Gut 1977, 18:115–120.

    Article  PubMed  CAS  Google Scholar 

  4. Tan WC, Allan RN: Diffuse jejunoileitis of Crohn’s disease. Gut 1993, 34:1374–1378.

    Article  PubMed  CAS  Google Scholar 

  5. Freeman HJ: Long-term clinical behavior of jejunoileal involvement in Crohn’s disease. Can J Gastroenterol 2005, 19:575–578.

    PubMed  Google Scholar 

  6. Poggioli G, Stocchi L, Laureti S, et al.: Duodenal involvement of Crohn’s disease: three different clinicopathologic patterns. Dis Colon Rectum 1997, 40:179–183.

    Article  PubMed  CAS  Google Scholar 

  7. Lenaerts C, Roy CC, Vaillancourt M, et al.: High incidence of upper gastrointestinal tract involvement in children with Crohn disease. Pediatrics 1989, 83:777–781.

    PubMed  CAS  Google Scholar 

  8. Sawczenko A, Sandhu BK: Presenting features of inflammatory bowel disease in Great Britain and Ireland. Arch Dis Child 2003, 88:995–1000.

    Article  PubMed  CAS  Google Scholar 

  9. Korelitz BI, Waye JD, Kreuning J, et al.: Crohn’s disease in endoscopic biopsies of the gastric antrum and duodenum. Am J Gastroenterol 1981, 76:103–109.

    PubMed  CAS  Google Scholar 

  10. Cameron DJ: Upper and lower gastrointestinal endoscopy in children and adolescents with Crohn’s disease: a prospective study. J Gastroenterol Hepatol 1991, 6:355–358.

    Article  PubMed  CAS  Google Scholar 

  11. Castellaneta SP, Afzal NA, Greenberg M, et al.: Diagnostic role of upper gastrointestinal endoscopy in pediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2004, 39:257–261.

    Article  PubMed  CAS  Google Scholar 

  12. Lemberg DA, Clarkson CM, Bohane TD, Day AS: Role of esophagogastroduodenoscopy in the initial assessment of children with inflammatory bowel disease. J Gastroenterol Hepatol 2005, 20:1696–1700.

    Article  PubMed  Google Scholar 

  13. Nguyen GC, Torres EA, Regueiro M, et al.: Inflammatory bowel disease characteristics among African Americans, Hispanics, and non-Hispanic Whites: characterization of a large North American cohort. Am J Gastroenterol 2006, 101:1012–1023.

    Article  PubMed  Google Scholar 

  14. Heyman MB, Kirschner BS, Gold BD, et al.: Children with early-onset inflammatory bowel disease (IBD): analysis of a pediatric IBD consortium registry. J Pediatr 2005, 146:35–40.

    Article  PubMed  Google Scholar 

  15. Gasche C, Scholmerich J, Brynskov J, et al.: A simple classification of Crohn’s disease: report of the Working Party for the World Congresses of Gastroenterology, Vienna 1998. Inflamm Bowel Dis 2000, 6:8–15.

    PubMed  CAS  Google Scholar 

  16. Silverberg MS, Satsangi J, Ahmad T, et al.: Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a Working Party of the 2005 Montreal World Congress of Gastroenterology. Can J Gastroenterol 2005, 19(Suppl A):5–36.

    PubMed  Google Scholar 

  17. Inflammatory bowel disease in children and adolescents: recommendations for diagnosis—the Porto criteria. J Pediatr Gastroenterol Nutr 2005, 41:1–7.

  18. Bousvaros A, Antonioli DA, Colletti RB, et al.: Differentiating ulcerative colitis from Crohn disease in children and young adults: report of a working group of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the Crohn’s and Colitis Foundation of America. J Pediatr Gastroenterol Nutr 2007, 44:653–674.

    Article  PubMed  Google Scholar 

  19. Terashima S, Hoshino Y, Kanzaki N, et al.: Ulcerative duodenitis accompanying ulcerative colitis. J Clin Gastroenterol 2001, 32:172–175.

    Article  PubMed  CAS  Google Scholar 

  20. Kaufman SS, Vanderhoof JA, Young R, et al.: Gastroenteric inflammation in children with ulcerative colitis. Am J Gastroenterol 1997, 92:1209–1212.

    PubMed  CAS  Google Scholar 

  21. Tobin JM, Sinha B, Ramani P, et al.: Upper gastrointestinal mucosal disease in pediatric Crohn disease and ulcerative colitis: a blinded, controlled study. J Pediatr Gastroenterol Nutr 2001, 32:443–448.

    Article  PubMed  CAS  Google Scholar 

  22. Rubenstein J, Sherif A, Appelman H, Chey WD: Ulcerative colitis associated enteritis: is ulcerative colitis always confined to the colon? J Clin Gastroenterol 2004, 38:46–51.

    Article  PubMed  Google Scholar 

  23. Ruuska T, Vaajalahti P, Arajarvi P, Maki M: Prospective evaluation of upper gastrointestinal mucosal lesions in children with ulcerative colitis and Crohn’s disease. J Pediatr Gastroenterol Nutr 1994, 19:181–186.

    PubMed  CAS  Google Scholar 

  24. Oberhuber G, Hirsch M, Stolte M: High incidence of upper gastrointestinal tract involvement in Crohn’s disease. Virchows Arch 1998, 432:49–52.

    Article  PubMed  CAS  Google Scholar 

  25. Schmidt-Sommerfeld E, Kirschner BS, Stephens JK: Endoscopic and histologic findings in the upper gastrointestinal tract of children with Crohn’s disease. J Pediatr Gastroenterol Nutr 1990, 11:448–454.

    Article  PubMed  CAS  Google Scholar 

  26. Heller T, James SP, Drachenberg C, et al.: Treatment of severe esophageal Crohn’s disease with infliximab. Inflamm Bowel Dis 1999, 5:279–282.

    PubMed  CAS  Google Scholar 

  27. Ho IK, Guarino DP, Pertsovskiy Y, Cerulli MA: Infliximab treatment of an esophagobronchial fistula in a patient with extensive Crohn’s disease of the esophagus. J Clin Gastroenterol 2002, 34:488–489.

    Article  PubMed  Google Scholar 

  28. Grubel P, Choi Y, Schneider D, et al.: Severe isolated Crohn’s-like disease of the gastroduodenal tract. Dig Dis Sci 2003, 48:1360–1365.

    Article  PubMed  Google Scholar 

  29. Knapp AB, Mirsky FJ, Dillon EH, Korelitz BI: Successful infliximab therapy for a duodenal stricture caused by Crohn’s disease. Inflamm Bowel Dis 2005, 11:1123–1125.

    Article  PubMed  Google Scholar 

  30. Theodoropoulou A, Koutroubakis IE, Kouroumalis EA: Treatment of oesophageal Crohn’s disease with infliximab. Eur J Gastroenterol Hepatol 2004, 16:431–432.

    Article  PubMed  Google Scholar 

  31. Hanauer SB, Feagan BG, Lichtenstein GR, et al.: Maintenance infliximab for Crohn’s disease: the ACCENT I randomised trial. Lancet 2002, 359:1541–1549.

    Article  PubMed  CAS  Google Scholar 

  32. Mottet C, Juillerat P, Gonvers JJ, et al.: Treatment of gastroduodenal Crohn’s disease. Digestion 2005, 71:37–40.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Hospital for Sick Children, 555 University Avenue, Toronto, M5G-1X8, Canada

    Anne M. Griffiths

Authors
  1. Dan Turner
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anne M. Griffiths
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anne M. Griffiths.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Turner, D., Griffiths, A.M. Esophageal, gastric, and duodenal manifestations of IBD and the role of upper endoscopy in IBD diagnosis. Curr Gastroenterol Rep 11, 234–237 (2009). https://doi.org/10.1007/s11894-009-0036-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11894-009-0036-0

Keywords

Search

Navigation