T. Weinstein et al., ESOPHAGEAL CROHNS-DISEASE - MEDICAL-MANAGEMENT AND CORRELATION BETWEEN CLINICAL, ENDOSCOPIC, AND HISTOLOGIC FEATURES, Inflammatory bowel diseases, 3(2), 1997, pp. 79-83
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.