Paper

Upper Gastrointestinal Crohn's Disease
Christian Mottet^a, Pascal Juillerat^a, Valérie Pittet^c, Jean-Jacques Gonvers^a, Pierre Michetti^a, John-Paul Vader^c, Christian Felley^a, Florian Froehlich<sup>a, b

a</sup>Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne,
^bGastrointestinal Department, University of Basle, Basle, and
^cHealthcare Evaluation Unit, Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland

Address of Corresponding Author

Digestion 2007;76:136-140 (DOI: 10.1159/000111028)

  Key Words

• Crohn's disease
• Esophagus
• Stomach
• Duodenum
• Stenosis

  Abstract

Symptomatic gastroduodenal manifestations of Crohn's disease are rare, with less than 4% of patients being clinically symptomatic. Gastroduodenal involvement may, however, be found endoscopically in 20% and in up to 40% of cases histologically, most frequently as Helicobacter pylori-negative focal gastritis, usually in patients with concomitant distal ileal disease. In practice, the activity of concomitant distal Crohn's disease usually determines the indication for therapy, except in the presence of obstructive gastroduodenal symptoms. With the few data available, it seems correct to say that localized gastroduodenal disease should be treated with standard medical therapy used for more distal disease, with the exception of the galenic formulation of sulfasalazine and mesalazine with pH-dependent release. The presence of symptoms of obstruction needs aggressive therapy. If medical therapy with steroids and immunomodulatory drugs does not alleviate the symptoms, balloon dilation and surgery are the options to consider.

Copyright © 2008 S. Karger AG, Basel

  Author Contacts

Christian Mottet, MD, PhD
Division of Gastroenterology and Hepatology
Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46
CH-1011 Lausanne (Switzerland)
Tel. +41 21 314 06 83, Fax +41 21 314 07 07, E-Mail christian.mottet@chuv.ch

  Article Information

Published online: February 7, 2008
Number of Print Pages : 5
Number of Figures : 0, Number of Tables : 0, Number of References : 51