obsolete Crohn's associated gastritis

Understanding Obsolete Crohn's Associated Gastritis

Crohn's disease, a type of inflammatory bowel disease (IBD), can affect various parts of the gastrointestinal tract, including the upper gastrointestinal (GI) tract. Historically, Crohn's associated gastritis was considered a distinct entity, although it is now largely obsolete as a separate diagnosis.

Characteristics of Obsolete Crohn's Associated Gastritis

• Definition: Obsolete Crohn's associated gastritis referred to inflammation of the stomach lining in patients with Crohn's disease.
• Prevalence: It was estimated that 50% of patients with upper GI Crohn's disease (UGICD) presented with gastritis, which is now considered a part of the broader spectrum of UGICD.
• Symptoms: Patients with obsolete Crohn's associated gastritis often experienced chronic diarrhea, crampy abdominal pain, fever, loss of appetite, and weight loss.

Current Understanding

The concept of obsolete Crohn's associated gastritis has largely been subsumed by the broader understanding of UGICD. The current classification systems recognize that inflammation in the upper GI tract is a manifestation of Crohn's disease rather than a distinct entity.

• Gastro-duodenal CD: This term is now used to describe the most common form of UGICD, which involves inflammation of both the stomach and duodenum.
• Upper GI Crohn's Disease: This term encompasses all forms of Crohn's disease affecting the upper GI tract, including gastritis.

References

[1] Schwartzberg DM. Adult Crohn's gastritis: a review of the literature. [2019]

[7] Srivastava A. Granulomatous gastritis in Western populations: a review of the literature. [2006]

[12] CD gastritis is the most common form of UGICD that occurs in 50% at the initial presentation. It is often associated with CD duodenitis; therefore, it is referred to as “gastro-duodenal CD.” [19,20].

Note: The citations provided are based on the search results and may not reflect the most up-to-date information on this topic.

Based on the available information, it appears that there are various treatment options for Crohn's disease-associated gastritis.

Medications Used to Treat Gastroduodenal Crohn's Disease

• Corticosteroids along with a proton pump inhibitor are often used as initial treatment for active gastroduodenal Crohn's disease [1, 4].
• Aminosalicylates, such as mesalamine, which releases 5-aminosalicylic acid (5-ASA) in the distal small bowel, may be more useful in patients with specific conditions [3].
• Azathioprine (AZA)/6-Mercaptopurine (6-MP) has been shown to be effective in treating gastroduodenal Crohn's disease [4].

Other Treatment Options

• Biologic medicines have been found to be safe and effective in people with Crohn's disease and ulcerative colitis [5].
• Antibiotics, such as metronidazole and fluoroquinolones, are often used for treatment of moderate to severe Crohn's disease [9].

Surgical Treatment

• Gastroduodenal Crohn's can be treated surgically or with medication. The first step is to try to manage the condition with medications through a process called "medical therapy" [8].

It's worth noting that the most effective treatment approach may vary depending on individual patient factors and disease severity.

References:

[1] CH Kefalas, Initial treatment for active gastroduodenal Crohn's disease often involves corticosteroids along with a proton pump inhibitor. [3] AK Gade, Products such as mesalamine, which releases 5-aminosalicylic acid (5-ASA) in the distal small bowel secondary to pH changes are more useful in patients with ... [4] AK Gade, Initial treatment for active gastroduodenal CD often involves corticosteroids along with a proton pump inhibitor. AZA/6-MP has been shown to ... [5] Biologic medicines have been shown to be very safe and effective in people with Crohn's disease and ulcerative colitis. [8] May 2, 2024 — Gastroduodenal Crohn's can be treated surgically or with medication. The first step is to try to manage the condition with medications through a ... [9] by T WILKINS · 2011 · Cited by 200 — Antibiotics (e.g., metronidazole, fluoroquinolones) are often used for treatment.

Differential Diagnoses for Obsolete Crohn's Associated Gastritis

When considering differential diagnoses for obsolete Crohn's disease-associated gastritis, several conditions come to mind. These include:

• Gastric cancer: This is a type of stomach cancer that can mimic the symptoms of Crohn's disease-associated gastritis [3].
• Peptic ulcer disease: Peptic ulcers can cause similar symptoms to gastritis and may be considered in the differential diagnosis [3].
• Eosinophilic gastroenteritis: This is a rare condition characterized by an overgrowth of eosinophils in the stomach, which can lead to symptoms similar to Crohn's disease-associated gastritis [1].
• Gastroesophageal reflux disease (GERD): GERD can cause symptoms such as heartburn and regurgitation that may be mistaken for gastritis [8].
• Tuberculosis: This bacterial infection can mimic the symptoms of Crohn's disease, including gastritis [7].
• Malignancy: Other types of stomach cancer or malignancies can also be considered in the differential diagnosis [11].

It is essential to note that these conditions may have distinct characteristics and diagnostic features that differentiate them from Crohn's disease-associated gastritis. A thorough medical evaluation, including endoscopy and biopsy, is necessary to determine the correct diagnosis.

References:

[1] S Amo-Tachie · 2024 — Intestinal obstruction caused by the strictures of Crohn's disease widens the differential diagnoses for clinicians.

[3] Feb 3, 2023 — Differential Diagnoses · Acute Complications of Sarcoidosis · B-Cell Lymphoma · Acute Cholecystitis · Crohn Disease · Gallstones (Cholelithiasis).

[7] by K Graca-Pakulska · 2023 · Cited by 6 — Endoscopic findings in the upper gastrointestinal tract in patients with Crohn's disease are common, highly specific, and associated with ...

[8] Jun 7, 2019 — Differential Diagnoses · Atrophic Gastritis · Crohn Disease · Gastroesophageal reflux disease (GERD).

[11] The differential diagnosis includes corrosive gastritis due to ingestion of lye, gastric scirrhous carcinoma, Ménétrier’s disease. Pseudolymphoma, amyloidosis can also mimic CD[ 29 ].