Three-Decade Review Assesses Adult Upper GI Crohn’s Disease | Gastro Today

A recent study reported prevalence estimates of adult patients with upper gastrointestinal Crohn’s disease (UGI-CD) and characterized the disease’s epidemiologic features over the last 3 decades.

Scoping Review Maps Trends in Adult Upper GI Crohn’s Disease

A team of researchers from Western University in Ontario, Canada conducted the study and published their findings in the Journal of Crohn’s and Colitis.

They underscored that although UGI “manifestations” of Crohn’s disease are commonly observed in pediatric populations, they are “underestimated” in adult populations. They also highlighted that limitations, such as inconsistent classification and selective endoscopy have “contributed to variable prevalence estimates.”

To identify and assess demographic variations and knowledge gaps in UGI-CD, in addition to estimating disease prevalence, the investigators conducted a scoping review across Embase, Cochrane CENTRAL, and MEDLINE.

Eligible studies included those with data from 1995 to November 2025 reporting prevalence and epidemiologic information on adult patients with UGI-CD. The scoping review was performed in accordance with PRISMA-ScR and JBI methodology.

Variables that were isolated from the eligible studies included estimated prevalence, site-level involvement, and demographic data. Overall, 117 primary studies and eight systematic reviews were included in the scoping review, which included 95 total patient cohorts with prevalence data.

The results demonstrated that the median prevalence of adult UGI-CD was 8.8% (IQR 3.99% – 14.5%) among cohorts with prevalence data. Patient cohorts that used systematic endoscopy and biopsy were found to have a higher prevalence of the disease compared to population-based patient cohorts.

Furthermore, the median prevalence of isolated cases of adult UGI-CD was 1.37%, which the investigators emphasized was “rare.” The scoping review also revealed geographic variation of prevalence estimates, in addition to variation across ethnic groups. Lower rates of the disease were observed in cohorts with South Asian patients, while higher rates were observed in cohorts with East Asian and Middle Eastern patients.

The findings showed inconsistent site-specific reporting, and the investigators reported that there was a lack of studies with modifier data on smoking or a family history of adult UGI-CD.

The investigators wrote that the reported prevalence estimates of the disease across 3 decades were “highly variable due to inconsistent definitions and detection strategies.”

“Standardized, site-specific adult definitions and systematic diagnostic protocols are needed to enable cross-study comparisons and thus improve prevalence estimates and address demographic reporting gaps,” they concluded.