#GOMEZ PEER INACTIVE SERIES#

All patients underwent an upper gastrointestinal endoscopy to rule out active Crohn's disease in the upper digestive tract and intestinal stenosis as cause of the symptoms. Colonoscopy with inspection of the terminal ileum was performed in every patient and biopsy specimens were taken for pathological examination. None of the patients had signs of active inflammation or stricture. All patients underwent a small bowel enteroclysis. We have reviewed the medical records of the cases who all had a severe symptoms of foregut dysmotility.Р”В«ecause of persistent symptoms of nausea, vomiting and in some cases weight loss patients were thoroughly evaluated. We identified four patients with Crohn's disease and one with indeterminate colitis who were diagnosed based upon accepted radiological, endoscopic and histological criteria. We selected cases with a diagnosis of IBD including Crohn's disease and ulcerative colitis who also had an impaired gastric emptying by matching the two data bases. We identified patients by a search of the morbidity database of the department of Gastroenterology and Hepatology which includes the ICD-9 diagnoses of975 patients with Crohn's disease and 821 patients with colitis ulcerosa referred between 19 and by a search of the gastric emptying database which includes 239 patients who underwent a scintigraphic gastric emptying study in our hospital between 19. The patients were all treated in our institute which is a tertiary referral centre for inflammatory bowel disease (IBD) in the Netherlands.

#GOMEZ PEER INACTIVE SERIES#

The aim of this case series is to describe clinical characteristics of five patients (four patients with inactive Crohn's disease and a single patient with indeterminate colitis) who had severe symptoms of gastroparesis which could not be attributed to mechanical obstruction or active inflammation, but who all had impaired gastric emptying of solid food.

Some reports indicate that upper gut motility can be impaired in patients with inactive Crohn's disease. Though local inflammation and intestinal obstruction may have important effects on gastrointestinal motility, motility studies in patients with Crohn's disease are scant. Symptoms indicative of gastroparesis, such as vomiting and bloating do occur in patients with Crohn's disease, but recurrent and/or persistent symptoms are rare and most clinicians attribute them to active inflammation or mechanical obstruction of the small or large bowel. Symptoms in these patients are refractory to various therapeutic interventions including tube feeding and gastric surgery.Р”В¬rohn's disease is a chronic inflammatory condition of unknown aetiology, which may involve the whole digestive tract from the oral cavity to the anus. ConclusionР”В¬linicians should consider impaired gastric emptying when evaluating patients with Crohn's disease and severe symptoms of upper gut dysmotility, which cannot be attributed to active inflammation or organic obstruction of the digestive tract.

All of the patients had markedly delayed gastric emptying with a mean t 1/2 of 234 minutes (range 110РІР‚вЂњ380 minutes normal values 54РІР‚вЂњ94 minutes). None of the patients had any signs of active inflammation or stricture. Small bowel enteroclysis, gastroduodenoscopy and colonoscopy with biopsies were performed to estimate the activity of the disease and to exclude organic obstruction. Gastric emptying of a solid meal was assessed by scintigraphy. We reviewed medical records of all cases. We describe a series of four patients with Crohn's disease and one with indeterminate colitis who presented with severe symptoms and signs of gastroparesis. The aim of this case series was to evaluate clinical characteristics of 5 patients with inflammatory bowel disease and symptoms and signs of upper gut dysmotility. Few studies have described patients with foregut dysmotility in inflammatory bowel disease.

Gomez peer inactive