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Peer-reviewedCC BYJournal of Crohn's & colitis

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

  • Daniel Lupas1
  • Navneet Natt2
  • Reyad Elzaanoun1
  • Yuhong Yuan2,3
  • Prince Taylor1,4
  • Rokhsana Mortuza3
  • Sudheer Vuyyuru2
  • Jurij Hanzel5
  • Christopher Ma6,7
  • Eileen Crowley8
  • Neeraj Narula9
  • Silvio Danese10
4 more authors
  • Laurent Peyrin-Biroulet11,12
  • Siddharth Singh13
  • Vipul Jairath2,3,14
  • Rocio Sedano2,3,14
14 affiliations
  1. 1Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
  2. 2Department of Medicine Division of Gastroenterology, Western University, London, ON, Canada.
  3. 3Lawson Health Research Institute, London, ON, Canada.
  4. 4Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
  5. 5Department of Gastroenterology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
  6. 6Division of Gastroenterology & Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
  7. 7Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
  8. 8Division of Pediatric Gastroenterology, Department of Pediatrics, Children's Hospital Western Ontario, Western University, London, Ontario, Canada.
  9. 9Division of Gastroenterology, Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
  10. 10Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and University Vita-Salute San Raffaele, Milano, Italy.
  11. 11Division of Gastroenterology and Hepatology, McGill University Health Centre, Montreal, Quebec, Canada.
  12. 12Department of Gastroenterology, CHRU Nancy, INSERM NGERE, Université de Lorraine, Vandœuvre-lès-Nancy, France.
  13. 13Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic Arizona, Scottsdale, AZ, United States.
  14. 14Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.
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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.

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Cite

BibTeXRIS
BibTeX
@article{lupas2026prevalence,
  title = {{Prevalence and epidemiologic features of adult upper gastrointestinal Crohn’s disease over the last 30 years: a scoping review}},
  author = {Daniel Lupas and Navneet Natt and Reyad Elzaanoun and Yuhong Yuan and Prince Taylor and Rokhsana Mortuza and Sudheer Vuyyuru and Jurij Hanzel and Christopher Ma and Eileen Crowley and Neeraj Narula and Silvio Danese and Laurent Peyrin-Biroulet and Siddharth Singh and Vipul Jairath and Rocio Sedano},
  journal = {Journal of Crohn's \& colitis},
  year = {2026},
  month = oct,
  doi = {10.1093/ecco-jcc/jjag168},
  url = {https://europepmc.org/article/PMC/PMC13722441},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Prevalence and epidemiologic features of adult upper gastrointestinal Crohn’s disease over the last 30 years: a scoping review
AU  - Daniel Lupas
AU  - Navneet Natt
AU  - Reyad Elzaanoun
AU  - Yuhong Yuan
AU  - Prince Taylor
AU  - Rokhsana Mortuza
AU  - Sudheer Vuyyuru
AU  - Jurij Hanzel
AU  - Christopher Ma
AU  - Eileen Crowley
AU  - Neeraj Narula
AU  - Silvio Danese
AU  - Laurent Peyrin-Biroulet
AU  - Siddharth Singh
AU  - Vipul Jairath
AU  - Rocio Sedano
PY  - 2026
DA  - 2026/10/01
JO  - Journal of Crohn's & colitis
DO  - 10.1093/ecco-jcc/jjag168
UR  - https://europepmc.org/article/PMC/PMC13722441
AB  - 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.
SN  - 1873-9946
SN  - 1876-4479
ER  -