Systematic review with meta-analysis: the prevalence, risk factors and outcomes of upper gastrointestinal tract Crohn's disease

Yip Han Chin*, Cheng Han Ng, Snow Yunni Lin, Sneha Rajiv Jain, Gwyneth Kong, Jeffery Wei Heng Koh, Darren Jun Hao Tan, David Eng Hui Ong, Mark Dhinesh Muthiah, Choon Seng Chong, Fung Joon Foo, Rupert Leong, Webber Pak Wo Chan

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

3 Citations (Scopus)


Aims: Upper gastrointestinal Crohn's disease (UGI-CD) is an important subclassification of Crohn's Disease (CD). We performed a systematic review and meta-analysis to evaluate the prevalence, risk factors, and clinical outcomes associated with UGI-CD. Methods: We searched Embase and Medline for articles reporting the clinical information of UGI-CD in CD patients, through 27 October 2020. Disease location and phenotype were coded according to the Montreal classification, and results were pooled with random effects by DerSimonian and Laird model. Results: 26 articles were included. The prevalence of UGI-CD was 13%. UGI-CD was most commonly found in the stomach (56%) and was associated with concurrent ileocolonic involvement (54%). Non-stricturing, non-penetrating UGI-CD was the most common behavioral phenotype (61%). L4-jejunal disease was associated with the highest rates of surgery. Region of origin did not significantly influence the location and phenotype of UGI-CD. Young, male patients presenting with erythema nodosum, aphthous ulcers and stricturing-phenotype are more likely to have UGI-CD, which in turn is linked to increased risk of hospitalization and surgery. Conclusion: UGI-CD is present in 13% of patients with CD, and patients with L4-jejunal disease are more likely to require surgery. Further studies examining the effect of ethnicity and region on UGI-CD are needed.

Original languageEnglish
Pages (from-to)1548-1558
Number of pages11
JournalDigestive and Liver Disease
Issue number12
Early online date16 Aug 2021
Publication statusPublished - Dec 2021
Externally publishedYes


  • Crohn's disease
  • Epidemiology
  • Montreal classification
  • Upper gastrointestinal Crohn's disease


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