Impact of Upper Gastrointestinal Involvement on Clinical Outcomes in Paediatric Inflammatory Bowel Disease
Ofek Aloni, Adi Anafy, Hadar Moran‐Lev, Achiya Amir, Alma Ziv, Reut Doyev, Tut Galai, Shlomi Cohen, Anat Yerushalmy‐FelerABSTRACT
Aim
The aim of this study was to assess the clinical implications of upper gastrointestinal (UGI) involvement in paediatric inflammatory bowel disease (IBD).
Methods
This retrospective cohort study included children diagnosed with IBD between 2010 and 2023, who underwent a UGI endoscopic evaluation at diagnosis and were followed for at least 12 months. Demographic, clinical, laboratory, endoscopic and histologic data were collected. Outcomes included clinical remission, biomarker remission, need for biologic therapy, IBD‐related hospitalizations and IBD‐related surgeries.
Results
UGI involvement was observed in 210 of 310 (68%) children, with a higher prevalence in CD compared to UC (73% vs. 57%, p = 0.004). Children with UGI involvement had a significantly lower probability to achieve clinical remission (Hazard ratio [HR] = 0.76, 95% confidence interval [CI] 0.59–0.98, p = 0.035) and biomarker remission (HR = 0.60, 95% CI 0.45–0.78, p < 0.001) and were more likely to initiate biologic therapy (HR = 1.77, 95% CI 1.24–2.52, p = 0.001).
Conclusion
UGI involvement is associated with a more severe course of IBD in children and characterized by lower rates of clinical and biomarker remission and a higher likelihood of initiating biologic therapy. These findings highlight the importance of early endoscopic evaluation of the UGI tract in paediatric IBD to guide monitoring and treatment strategies.