ESOPHAGEAL CROHNS-DISEASE - MEDICAL-MANAGEMENT AND CORRELATION BETWEEN CLINICAL, ENDOSCOPIC, AND HISTOLOGIC FEATURES

Esophageal involvement in patients with Crohn's disease, initially tho ught to be rare, has been documented with increasing frequency in both retrospective and prospective studies. However, there is no documente d standardized medical regimen for treatment of these patients. We rep ort five cases of esophageal Crohn's disease as well as a review of th e literature emphasizing therapeutic approach and increased incidence of corticosteroid dependence in these patients. In the past, patients with significant esophageal disease and symptoms have been surgical ca ndidates. We recommend that all patients with symptoms of dysphagia, o dynophagia, chest pain, or dyspepsia with documented esophageal Crohn' s disease should receive H-2 receptor antagonists as part of their med ical regimen. In addition, immunosuppressant agents should be consider ed as adjuvant therapy in steroid-dependent patients with esophageal d isease involvement.