Work

Prevalence and epidemiologic features of adult upper gastrointestinal Crohn’s disease over the last 30 years: a scoping review

Year: 2026

Type: review

Abstract: BACKGROUND: Crohn's disease (CD) is an inflammatory bowel disease (IBD) that can affect any part of the gastrointestinal tract. Although upper gastrointestinal (UGI) manifestations are well recognized in pediatrics, UGI-CD in adults has historically been underestimated. Methodological limitations, including selective endoscopy and inconsistent classification, have contributed to variable prevalence estimates. AIMS: Our goals were to summarize the prevalence of UGI-CD in adults with CD, understand demographic variations, and summarize knowledge gaps. METHODS: We conducted a scoping review of MEDLINE, Embase, and Cochrane CENTRAL (1995-November 2025) using PRISMA-ScR and JBI methodology. Eligible studies reported adult UGI-CD prevalence or related epidemiologic data. Extracted variables included prevalence estimates, site-level involvement, and demographics. Systematic reviews were included to summarize review-level epidemiologic evidence. RESULTS: In total, 117 primary studies and eight systematic reviews were included. Across 95 cohorts with prevalence data, the median prevalence of UGI-CD was 8.8% (IQR 3.99%-14.5%). Higher rates were observed in cohorts using systematic endoscopy and biopsy, while population-based cohorts reported lower values. Isolated UGI-CD was rare, with a median prevalence of 1.37% (IQR 0.87%-3.02%). Prevalence varied geographically and ethnically, with lowest rates in South Asian cohorts and higher rates in East Asian and Middle Eastern cohorts. Site-specific reporting was inconsistent, and few studies detailed modifiers such as smoking or family history. CONCLUSIONS: Reported prevalence estimates of adult UGI-CD remain 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.

Source: Journal of Crohn s and Colitis

DOI: 10.1093/ecco-jcc/jjag168