A patient with an inflammatory bowel disease (IBD, Crohn's disease, ulcerative colitis) may develop significant inflammation in the stomach and/or duodenum. The presence of both upper and lower gastrointestinal symptoms should alert the clinician to the possibility of an inflammatory bowel disease.


Inflammatory bowel disease involving the upper GI tract may cause:

(1) focal or diffuse gastritis

(2) focal or diffuse duodenitis

(3) focal or diffuse esophagitis


The inflammatory cell infiltrates may consist of:

(1) plasmacytosis in ulcerative colitis (differential diagnosis gastric syphilis)

(2) noncaseating granulomas in Crohn's disease

(3) mucosal ulcerations (differential diagnosis peptic ulcer disease and other conditions)

(4) villous atrophy in the duodenum (differential diagnosis celiac disease)

(5) cryptitis


Other forms of gastritis or duodenitis may occur concurrently - Helicobacter gastritis, chemical gastropathy, celiac disease, etc. Persistence of inflammation following treatment of these conditions supports the diagnosis of IBD-related inflammation.


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