Systematic review with meta-analysis: The prevalence, risk factors and outcomes of upper gastrointestinal tract Crohn's disease. Issue 12 (December 2021)

• Record Type: Journal Article
• Authors: Chin, Yip Han; Ng, Cheng Han; Lin, Snow Yunni; Jain, Sneha Rajiv; Kong, Gwyneth; Koh, Jeffery Wei Heng; Tan, Darren Jun Hao; Ong, David Eng Hui; Muthiah, Mark Dhinesh; Chong, Choon Seng; Foo, Fung Joon; Leong, Rupert; Chan, Webber Pak Wo
• Is Part Of: Digestive and liver disease. Volume 53:Issue 12(2021)
• Page Start: 1548
• Page End: 1558
• Publication Date: 2021-12
• Subjects: Upper gastrointestinal Crohn's disease -- Crohn's disease -- Epidemiology -- Montreal classification; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; 616.33005
• DOI: 10.1016/j.dld.2021.07.037
• Languages: English
• ISSNs: 1590-8658

Abstract

Abstract: Aims: Upper gastrointestinal Crohn's disease (UGI-CD) is an important subclassification of Crohn's Disease (CD). We performed a systematic review and meta-analysis to evaluate the prevalence, risk factors, and clinical outcomes associated with UGI-CD. Methods: We searched Embase and Medline for articles reporting the clinical information of UGI-CD in CD patients, through 27 October 2020. Disease location and phenotype were coded according to the Montreal classification, and results were pooled with random effects by DerSimonian and Laird model. Results: 26 articles were included. The prevalence of UGI-CD was 13%. UGI-CD was most commonly found in the stomach (56%) and was associated with concurrent ileocolonic involvement (54%). Non-stricturing, non-penetrating UGI-CD was the most common behavioral phenotype (61%). L4-jejunal disease was associated with the highest rates of surgery. Region of origin did not significantly influence the location and phenotype of UGI-CD. Young, male patients presenting with erythema nodosum, aphthous ulcers and stricturing-phenotype are more likely to have UGI-CD, which in turn is linked to increased risk of hospitalization and surgery. Conclusion: UGI-CD is present in 13% of patients with CD, and patients with L4-jejunal disease are more likely to require surgery. Further studies examining the effect of ethnicity and region on UGI-CD are needed.