Frequency and clinical significance of histologic upper gastrointestinal tract findings in children with inflammatory bowel disease

Marleena Repo, Johanna Pessi, Eelis Wirtanen, Pauliina Hiltunen, Heini Huhtala, Laura Kivelä, Kalle Kurppa

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Objective: Assessment of the upper gastrointestinal tract (UGI) may enable more personalized treatment strategies in pediatric inflammatory bowel disease (IBD). However, data on the frequency and significance of these findings remain limited. Methods: Data on 132 pediatric IBD patients with systematic UGI sampling were collected and the baseline characteristics and presence of complications compared between those with and without histological UGI findings. The control group comprised 162 children who received no diagnoses. Results: Seventy-six children had ulcerative colitis (UC), 47 Crohn’s disease (CD) and nine IBD unclassified. UGI findings were more common in IBD patients than controls (69.7% vs. 30.9%, respectively, p <.001), particularly in the stomach (62.1% vs. 16.8%; p <.001). Among IBD patients, findings were more common in CD than in UC (80.9% vs. 63.2%; p =.038), particularly in the duodenum (21.3% vs. 2.6%, p =.001). Four patients had UGI granulomas consistent with CD. Hypoalbuminemia (OR 3.22; 95% CI 1.18–8.79) and failure to thrive (2.82; 1.17–6.78) increased the likelihood of UGI findings in IBD. In CD, perianal morbidity was less common in those with than in those without UGI findings (13.2% vs. 44.4%; p =.032) whereas in UC, UGI findings increased the risk for co-morbidities (18.8% vs. 3.6%; p =.059). The long-term outcomes did not differ between patients with or without UGI findings. Conclusions: Histologic UGI findings were more common in children with IBD than in children with no gastrointestinal diagnoses. In CD, UGI findings were more frequent than in UC, especially in the duodenum. In UC, UGI findings were associated with more complex disease.

Original languageEnglish
Pages (from-to)1046-1050
Number of pages5
JournalScandinavian Journal of Gastroenterology
Issue number9
Publication statusPublished - 2022
Publication typeA1 Journal article-refereed


  • biopsy
  • Crohn’s disease
  • duodenitis
  • esophagitis
  • esophagogastroduodenoscopy
  • gastritis
  • Inflammatory bowel disease
  • ulcerative colitis

Publication forum classification

  • Publication forum level 1

ASJC Scopus subject areas

  • Gastroenterology


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