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Gastric lesions in patients with Crohn's disease in Korea: a multicenter study
Hoonsub So1, Byong Duk Ye2, Young Soo Park3
1Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Insights
Gastric pathology in Crohn's disease (CD) patients remains unclear. This study found H. pylori-negative gastritis is common in Korean CD patients, with granulomas potentially predicting perianal complications.
Area of Science:
- Gastroenterology
- Pathology
- Microbiology
Background:
- Gastric pathology and Helicobacter pylori (H. pylori) infection are not well understood in Asian patients with Crohn's disease (CD).
- This study aimed to clarify gastric histologic features and H. pylori infection rates in Korean CD patients.
Purpose of the Study:
- To evaluate gastric histologic findings and the prevalence of H. pylori infection in Korean patients diagnosed with Crohn's disease.
- To investigate potential associations between gastric pathology and clinical manifestations of CD.
Main Methods:
- Retrospective analysis of upper gastrointestinal endoscopic and histopathologic data from 47 Korean CD patients.
- H. pylori infection was diagnosed using rapid urease testing and gastric biopsy histology.
Main Results:
- H. pylori-negative chronic active gastritis was the most frequent histopathologic finding (38.3%).
- H. pylori infection was detected in 23.4% of patients.
- Gastric noncaseating granulomata were found in 8.5% of patients and significantly associated with perianal abscess/fistula (P=0.0496).
Conclusions:
- H. pylori-negative chronic active gastritis is prevalent in Korean CD patients.
- The H. pylori infection rate is comparable to previous studies.
- Gastric noncaseating granuloma may serve as a prognostic marker for perianal complications in CD.
Background/Aims:
Gastric pathology and Helicobacter pylori (H. pylori) infection among Asian patients with Crohn's disease (CD) are still unclear. We evaluated gastric histologic features and frequency of H. pylori infection in Korean patients with CD.
Methods:
Among 492 patients with CD receiving upper gastrointestinal (GI) endoscopic evaluation in 19 Korean hospitals, we evaluated the endoscopic findings and gastric histopathologic features of 47 patients for our study. Histopathologic classification was performed using gastric biopsy tissues, and H. pylori infection was determined using the rapid urease test and histology.
Results:
There were 36 men (76.6%), and the median age of patients at the time of upper GI endoscopy was 23.8 years (range, 14.2-60.5). For CD phenotype, ileocolonic disease was observed in 38 patients (80.9%), and non-stricturing, non-penetrating disease in 31 patients (66.0%). Twenty-eight patients (59.6%) complained of upper GI symptoms. Erosive gastritis was the most common gross gastric feature (66.0%). Histopathologically, H. pylori-negative chronic active gastritis (38.3%) was the most frequent finding. H. pylori testing was positive in 11 patients (23.4%), and gastric noncaseating granulomata were detected in 4 patients (8.5%). Gastric noncaseating granuloma showed a statistically significant association with perianal abscess/fistula (P=0.0496).
Conclusions:
H. pylori-negative chronic active gastritis appears to be frequent among Korean patients with CD. The frequency of H. pylori infection was comparable with previous studies. An association with perianal complications suggests a prognostic value for gastric noncaseating granuloma in patients with CD.
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