Upper Gastrointestinal Involvement in Crohn's Disease as an Independent Predictor of New-Onset Strictures: Insights from an Extensive Retrospective Cohort Analysis.

التفاصيل البيبلوغرافية
العنوان:	Upper Gastrointestinal Involvement in Crohn's Disease as an Independent Predictor of New-Onset Strictures: Insights from an Extensive Retrospective Cohort Analysis.
المؤلفون:	Hsu WC; School of Medicine, Chang Gung University, Taoyuan, Taiwan., Chen CM; Chang Gung Inflammatory Bowel Disease Center, Taoyuan, Taiwan.; Department of Medical Imaging and Interventions, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan., Kuo CJ; Chang Gung Inflammatory Bowel Disease Center, Taoyuan, Taiwan.; Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Branch, 5, Fu-Hsin Street, Guei-Shan District, Taoyuan, 33305, Taiwan.; Taiwan Association for the Study of Small Intestinal Diseases (TASSID), Taoyuan, Taiwan., Tsou YK; Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Branch, 5, Fu-Hsin Street, Guei-Shan District, Taoyuan, 33305, Taiwan., Yeh PJ; Chang Gung Inflammatory Bowel Disease Center, Taoyuan, Taiwan.; Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan., Lai MW; Chang Gung Inflammatory Bowel Disease Center, Taoyuan, Taiwan.; Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan., Wu RC; Chang Gung Inflammatory Bowel Disease Center, Taoyuan, Taiwan.; Department of Anatomic Pathology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan., Chiu CT; Chang Gung Inflammatory Bowel Disease Center, Taoyuan, Taiwan.; Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Branch, 5, Fu-Hsin Street, Guei-Shan District, Taoyuan, 33305, Taiwan.; Taiwan Association for the Study of Small Intestinal Diseases (TASSID), Taoyuan, Taiwan., Su MY; Taiwan Association for the Study of Small Intestinal Diseases (TASSID), Taoyuan, Taiwan.; Department of Gastroenterology and Hepatology, New Taipei City Municipal Tucheng Hospital, New Taipei City, Taiwan., Pan YB; Biostatistical Section, Clinical Trial Centre, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan., Le PH; Chang Gung Inflammatory Bowel Disease Center, Taoyuan, Taiwan. puohsien@gmail.com.; Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Branch, 5, Fu-Hsin Street, Guei-Shan District, Taoyuan, 33305, Taiwan. puohsien@gmail.com.; Taiwan Association for the Study of Small Intestinal Diseases (TASSID), Taoyuan, Taiwan. puohsien@gmail.com.
المصدر:	Digestive diseases and sciences [Dig Dis Sci] 2024 Aug 01. Date of Electronic Publication: 2024 Aug 01.
Publication Model:	Ahead of Print
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: Springer Science + Business Media Country of Publication: United States NLM ID: 7902782 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-2568 (Electronic) Linking ISSN: 01632116 NLM ISO Abbreviation: Dig Dis Sci Subsets: MEDLINE
أسماء مطبوعة:	Publication: 2005- : New York, NY : Springer Science + Business Media Original Publication: New York, Plenum Pub. Corp.
مستخلص:	Background/aims: Crohn's Disease (CD) can affect the entire gastrointestinal tract, including the upper sections (UGI), which is often overlooked, especially in Asian populations. There's a notable gap in research regarding the impact of UGI involvement on the intricate landscape of ensuing complications. This study aims to address this gap. Methods: Conducting a retrospective study at Chang Gung Memorial Hospital from January 2001 to September 2023, we compared CD patients with UGI (Montreal L4) involvement against non-L4 counterparts, focusing on baseline characteristics, post-diagnosis complications, and overall outcomes. Routine UGI endoscopy was performed around the time of diagnosis in all patients followed in our inflammatory bowel disease (IBD) center, and all CD patients with adequate follow-up were included in this study. Results: The study included 212 CD patients, 111 in the L4 group and 101 in the non-L4 group, with an average follow-up of 40.8 ± 15.1 months. At baseline, individuals in the L4 category demonstrated elevated smoking rates, increased Crohn's Disease Activity Index scores, a higher prevalence of strictures, and a more prevalent usage of biologics and proton pump inhibitors. Moreover, this group was characterized by reduced albumin levels. Upon concluding the follow-up, those with L4 involvement continued to show escalated CDAI scores and hospitalization frequencies, alongside heightened C-reactive protein levels and diminished albumin concentrations. Additionally, the occurrence of UGI involvement, stricturing disease at the time of diagnosis, and a younger age at the onset of CD were pinpointed as independent predictors for the development of new-onset strictures. Conclusions: CD patients with UGI involvement exhibit elevated disease activity and serve as independent predictors for the development of intestinal strictures. Thorough UGI evaluations at the time of diagnosis, coupled with assertive treatment strategies, are essential for managing these patients effectively. (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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فهرسة مساهمة:	Keywords: Crohn’s disease; L4; Stricture; Upper gastrointestinal tract
تواريخ الأحداث:	Date Created: 20240801 Latest Revision: 20240801
رمز التحديث:	20240802
DOI:	10.1007/s10620-024-08577-5
PMID:	39090445
قاعدة البيانات:	MEDLINE

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تدمد:	1573-2568
DOI:	10.1007/s10620-024-08577-5