Purpose: The aim of this study is to determine the involvement of the upper gastrointestinal system (GIS) in patients diagnosed with Crohn's disease (CD), ulcerative colitis (UC), and non-inflammatory bowel disease (IBD) and to compare their differences. Methods: This study included patients aged be...
Purpose: The aim of this study is to determine the involvement of the upper gastrointestinal system (GIS) in patients diagnosed with Crohn's disease (CD), ulcerative colitis (UC), and non-inflammatory bowel disease (IBD) and to compare their differences. Methods: This study included patients aged between 2 and 18 years who underwent colonoscopy and esophagogastroduodenoscopy (EGD) for the first time due to the prediagnosis of IBD. In EGD, samples were taken from duodenum, antrum, corpus, and esophagus; and gastritis, duodenitis, and esophagitis were identified through histopathologic examination. The data gathered the ends of the research were compared between IBD with non-IBD groups and between CD-UC with non-IBD groups, and the presence of significant differences between groups were determined. Results: In our study, 16 patients were diagnosed with CD, 13 with UC, 3 with undeterminate colitis, and 13 with non-IBD. In the histopathological examination of the groups, GIS involvement was found in 94.1% of patients diagnosed with IBD and in 38.5% of non-IBD patients. Moreover, the difference was found to be statistically significant (p=0.032). No significant difference was found between the CD and UC groups. Gastritis was mostly observed in 93.8% of CD-diagnosed patients, 76.8% of UC-diagnosed patients, 81.2% of IBD-diagnosed patients, and 38.5% of non-IBD-diagnosed patients. On the other hand, significant differences were found between CD and non-IBD groups (p=0.03), UC and non-IBD groups (p=0.047), and IBD and non-IBD groups (p=0.03). Conclusion: The results of the study show that gastritis was highly observed in UC- and CD-diagnosed patients than in non-IBD-diagnosed patients.
Purpose: The aim of this study is to determine the involvement of the upper gastrointestinal system (GIS) in patients diagnosed with Crohn's disease (CD), ulcerative colitis (UC), and non-inflammatory bowel disease (IBD) and to compare their differences. Methods: This study included patients aged between 2 and 18 years who underwent colonoscopy and esophagogastroduodenoscopy (EGD) for the first time due to the prediagnosis of IBD. In EGD, samples were taken from duodenum, antrum, corpus, and esophagus; and gastritis, duodenitis, and esophagitis were identified through histopathologic examination. The data gathered the ends of the research were compared between IBD with non-IBD groups and between CD-UC with non-IBD groups, and the presence of significant differences between groups were determined. Results: In our study, 16 patients were diagnosed with CD, 13 with UC, 3 with undeterminate colitis, and 13 with non-IBD. In the histopathological examination of the groups, GIS involvement was found in 94.1% of patients diagnosed with IBD and in 38.5% of non-IBD patients. Moreover, the difference was found to be statistically significant (p=0.032). No significant difference was found between the CD and UC groups. Gastritis was mostly observed in 93.8% of CD-diagnosed patients, 76.8% of UC-diagnosed patients, 81.2% of IBD-diagnosed patients, and 38.5% of non-IBD-diagnosed patients. On the other hand, significant differences were found between CD and non-IBD groups (p=0.03), UC and non-IBD groups (p=0.047), and IBD and non-IBD groups (p=0.03). Conclusion: The results of the study show that gastritis was highly observed in UC- and CD-diagnosed patients than in non-IBD-diagnosed patients.
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문제 정의
The Porto study group by the European Society for Paediatric Gastroenterology Hepatology and Nutrition recommends esophagogastroduodenoscopy (EGD) in all children suspected with IBD, and they also recommend the conduction of multiple biopsies and histopathological investigations on the upper GIS, namely stomach, duodenum, and esophagus [12,13]. The aim of our study is to conduct a prospective evaluation on patients suspected with IBD and to determine the involvement of upper GIS in patients diagnosed with CD, UC, and non-IBD and to compare the differences between these diseases.
제안 방법
For the definitive statistical analysis of the data, mean±standard deviation for numeric variables and numbers and percentages for the categorical data were used.
If the histopathological findings were not in line with IBD but were matching with diseases, such as infectious colitis, eosinophilic colitis, or nonspecific colitis, the patients were diagnosed with non-IBD instead. The records of the study were used for the comparison of IBD with non-IBD patients, CD with non-IBD patients, and UC with non-IBD patients, and for the evaluation of the statistical significance of the results as well.
대상 데이터
During our study, 57 patients with suspected IBD were evaluated. However, four patients due to refusal to EGD, four patients due to PPI usage, and one patient due to steroid usage were excluded.
Ileocolonoscopy and gastroscopy were performed to all the remaining 45 patients. Out of 45 patients enrolled in our study, 16 of them were diagnosed with CD, 13 with UC, three with IC, and 13 with non-IBD. The non-IBD group consisted of patients with infectious colitis (eight patients), eosinophilic colitis (two patients), and nonspecific colitis (three patients).
During the EGD, two biopsies were taken from antrum corpus and esophagus. The specimens were taken from macroscopically normal and inflamed mucosae. After formol fixation and paraffin wax embedding, all specimens were stained with hematoxylin-eosin.
This study included patients aged between 2 and 18 years who underwent colonoscopy and EGD for the first time due to the prediagnosis of IBD in the Pediatric Gastroenterology Endoscopy Unit of Akdeniz University from June 2015 to December 2015. This study received the approval of the ethics committee (No.
데이터처리
, Chicago, IL, USA). The comparison of the data was done through Mann-Whitney U-test, chi-square test, and Fisher exact test. For the definitive statistical analysis of the data, mean±standard deviation for numeric variables and numbers and percentages for the categorical data were used.
이론/모형
For the diagnosis of CD, UC, and IC, the diagnosis criteria of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and of the Crohn’s and Colitis Foundation of America, as determined through histopathological investigation of the biopsy conducted during the colonoscopy, were used [14].
성능/효과
According to the results of our study, the incidence of gastritis in the CD, UC, IBD, and non-IBD groups were 93.8%, 76.9%, 81.2%, and 38.5%, respectively. Although there was no significant difference between the CD and UC groups, the differences between CD and UC groups, UC and non-IBD groups, and IBD and non-IBD groups were statistically significant.
5%, respectively. Although there was no significant difference between the CD and UC groups, the differences between CD and UC groups, UC and non-IBD groups, and IBD and non-IBD groups were statistically significant. These findings are in line with the results of the study that focused on gastritis and showed that the gastritis rates were 72.
In conclusion, the result of our study show that GIS involvement is more frequent in children diagnosed with IBD, CD, and UC than in children with non-IBD condition, and it was significantly shown that the incidence of gastritis was observed higher in UC and CD groups than in the non-IBD group.
pylori gastritis is lower in the healthy population as compared to IBD group [30,31]. In our study, the incidence of H. pylori gastritis was 15.4% in non-IBD group, and the incidence of H. pylori gastritis was 3.1% and 6.3% in the IBD and CD groups, respectively. H.
The differences among the groups were not statistically significant. Similarly, the differences in esophagitis incidence among the groups were insignificant: 68.8% in CD, 59.3% in IBD, 46.2% in UC, and 38.5% in non-IBD groups.
The duodenitis incidence in the CD, UC, IBD, and non-IBD groups were 56.3%, 38.5%, 46.9%, and 23.1%, respectively. Although there was no significant difference, we observed a higher involvement of the CD group.
3% in IBD groups), and it was not observed in the UC and non-IBD groups. The highest incidence of the H. pylori gastritis was detected in the non-IBD group (15.4%), and H. pylori incidence was found in only one patient in the CD and IBD groups (6.3% and 3.12%, respectively) (Table 3).
032). The highest rate of duodenitis was found in the CD group (56.3%); and it was in 46.9% of IBD patients, 38.5% of UC patients, and 23.1% of non-IBD patients. The differences among the groups were not statistically significant.
pylori negative chronic active gastritis must be included in the definitive diagnosis of IBD [27-29]. The results of our study are in line with these data: the incidences of H. pylori negative chronic active gastritis were 43.7% in IBD, 50.0% in CD, 46.2% UC, and they were significantly higher in these groups as compared to the non-IBD group (23.1%).
In recent years, EGD became an intervention regarded as necessary by many authors for the diagnosis of suspected IBD in children [7-9]. The results of our study confirmed this opinion and indicated that EGD is necessary for the diagnosis of suspected IBD in children.
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