Abstract
Use of Dapsone for Difficult to Treat Stricturing Esophageal Crohn's Disease: A Difficult Pill to Swallow
Highlights
Crohn’s disease (CD) can affect any part of the gastrointestinal tract
Current guidelines do not recommend EGD as part of the evaluation to assess extent of disease in adults, it is worth considering in patients with features of IBD unclassified, dyspepsia or other esophageal symptoms [4]
Esophageal CD can fistulize into surrounding structures such as the tracheobronchial tree
Summary
Crohn’s disease (CD) can affect any part of the gastrointestinal tract. esophageal involvement is rare, it can lead to debilitating complications such as tracheobronchial fistulation. We report a case of stricturing esophageal Crohn’s disease refractory to conventional therapy that was successfully treated with endoscopic dilatation and oral dapsone. From 2008 to 2010 she was treated with ustekinumab and methotrexate but continued to have evidence of both clinical and endoscopically active disease. Given the isolated nature of the pathology in the mid-esophagus while on acid suppression therapy and lack of features consistent with other conditions, the esophagitis and stricture was thought to be consistent with foregut CD.
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