Abstract
(1) The aim of the present study was to describe the endoscopic and histopathological findings in the esophagus, stomach, and duodenum in patients with Crohn’s disease. (2) Methods: This was a cross-sectional study that included patients receiving treatment from the inflammatory bowel disease outpatient clinic. Esophagogastroduodenoscopies with biopsies of the stomach and proximal duodenum were performed. Presence of Helicobacter pylori bacteria was assessed by Giemsa staining. (3) Results: We included 58 patients. Erosive esophagitis was identified in 25 patients (43.1%), gastritis was diagnosed in 32 patients (55.2%) and erosive duodenitis was found in eight (13.8%). The most frequent histopathological finding in the H. pylori-positive group was increased inflammatory activity in the gastric body and antrum, with a predominance of mononuclear and polymorphonuclear cells. In turn, the most frequent finding in the H. pylori-negative group was chronic inflammation with predominance of mononuclear cells. Focally enhanced gastritis was identified in four patients (6.9%), all of whom were negative for H. pylori. Granulomas were not observed. H. pylori infection was present in 19 patients (32.8%). (4) Conclusions: Nonspecific endoscopic and histological findings were frequent in patients with Crohn’s disease. Focally enhanced gastritis was uncommon and observed only in H. pylori-negative patients. The time from the diagnosis, patient age, and therapy in use may have influenced the nondetection of epithelioid granuloma.
Highlights
The prevalence of upper gastrointestinal (GI) tract involvement in symptomatic patients with Crohn’s disease (CD) varies between 0.5 and 5% [1,2,3]
The presence of H. pylori was associated with increased inflammatory activity in the body and antrum, with a predominance of mononuclear and polymorphonuclear cells and permeation of inflammatory cells around the glands, whereas in the H. pylori-negative group, the inflammatory activity was discrete with a predominance of mononuclear cells (p < 0.05)
Nonspecific endoscopic and histopathological findings in the esophagus, stomach and duodenum were frequent in patients with CD
Summary
The prevalence of upper gastrointestinal (GI) tract involvement in symptomatic patients with Crohn’s disease (CD) varies between 0.5 and 5% [1,2,3]. In which esophagogastroduodenoscopy (EGD) was performed as a routine part of the diagnostic evaluation, have demonstrated a higher frequency of both endoscopic and histopathological findings [4,5]. There is no recommendation to perform EGD in asymptomatic adult patients with CD. Studies performed in the pediatric population have demonstrated that the involvement of the upper GI tract has a higher prevalence; it is recommended to perform EGD with biopsies of the upper gastrointestinal tract routinely at the time of diagnosis in pediatric patients [6,7]. The main histological findings described are chronic inflammation, lymphoid aggregates, fibrosis, focally enhanced gastritis (FEG), and epithelioid granulomas [9,10]
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