[Inflammatory bowel diseases and upper gastrointestinal tract]

Area of Science:

• Gastroenterology
• Internal Medicine
• Pathology

Context:

• Inflammatory bowel diseases (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), are chronic conditions characterized by intermittent flares and unknown causes.
• Increasingly, inflammatory lesions in the upper gastrointestinal tract are being reported in patients diagnosed with CD and UC.
• Understanding the upper GI manifestations is crucial for comprehensive IBD management.

Purpose:

• To systematically review and synthesize current literature on inflammatory lesions of the esophagus, stomach, and duodenum in the context of IBD.
• To provide an overview of the prevalence, clinical presentation, and endoscopic findings of upper GI involvement in IBD.
• To highlight the diagnostic challenges and therapeutic considerations for these upper tract lesions.

Summary:

• The review consolidates findings on esophageal, gastric, and duodenal inflammation observed in IBD patients.
• Commonly reported lesions include esophagitis, gastritis, and duodenitis, which can mimic other gastrointestinal disorders.
• The etiology of these upper GI lesions in IBD is multifactorial, potentially involving immune dysregulation, medication side effects, and microbial factors.

Impact:

• This review enhances the understanding of the full spectrum of IBD manifestations, extending beyond the typical lower GI tract involvement.
• It provides clinicians with valuable information for diagnosing and managing upper gastrointestinal inflammatory lesions in IBD patients.
• The findings underscore the importance of considering upper endoscopy in the diagnostic workup of IBD patients presenting with relevant symptoms.