Crohn's Disease: The Complete Guide to Medical Management

Gary R. Lichtenstein, MD, FACP, FACG, AGAF

Chapter 32: Gastroduodenal/Proximal Crohn’s Disease (continued)

Ellen J. Scherl, MD, FACP, AGAF; Brian P. Bosworth, MD; Felice Schnoll-Sussman, MD; Douglas M. Weine, MD; Peter H. R. Green, MD

Proximal Crohn’s disease involving the stomach, duodenum, and jejunum is becoming increasingly recognized as a result of both better diagnostic tools, such as conventional upper endoscopy, chromoendoscopy, and wireless capsule endoscopy (WCE), as well as improved histologic characterization (eg, focally enhanced gastritis in the absence of Helicobacter pylori). CD and colitis may thus be a more proximal disease than previously recognized. As many as 30% to 50% of patients with established CD will have upper gastrointestinal involvement.1 Though the symptoms of gastroduodenal CD include…