Inflammatory bowel disease-related lesions in the duodenal and gastric mucosa

Objective. In 10-15% of patients with colorectal inflammatory bowel disease it is not possible to determine whether they have Crohn's disease or ulcerative colitis and they are therefore classified as having inflammatory bowel disease unclassified (IBDU) (formerly referred to as indeterminate colitis). The aim of this study was to determine whether upper endoscopy with biopsies could be a useful tool for diagnosing patients with colorectal inflammatory disease. Material and methods. Fifty-two patients (14 colorectal Crohn's disease, 19 ulcerative colitis, 6 IBDU, 8 microscopic colitis and 5 without IBD) were examined by upper endoscopy. Biopsies from gastric and duodenal mucosa were examined histologically and the frequency of focal cryptitides was estimated. Helicobacter pylori-positive patients were excluded. Results. Focal cryptitides (sometimes called focally enhanced gastritis) were found in 8/14 of patients with Crohn's disease, 4/19 patients with ulcerative colitis, 2/6 patients with IBDU, 2/8 of patients with microscopic colitis and in 2/5 patients without IBD. Conclusions. Focal cryptitides are more commonly found in gastric and/or duodenal mucosa in patients with colorectal Crohn's disease than in other patients. Upper endoscopy with mucosal biopsies contributes towards a diagnosis in patients with colitis.