Gastroduodenal Crohn’s disease is characterized by chronic inflammation in your stomach or the upper part of your small intestines called the duodenum.

Crohn’s disease is one of two conditions that make up inflammatory bowel disease (IBD), along with ulcerative colitis. It causes chronic inflammation that can affect any part of your gastrointestinal tract.

Gastroduodenal Crohn’s disease is one of the five subtypes of Crohn’s disease. It’s estimated to occur in 0.5–4% of people with Crohn’s.

The other four subtypes of Crohn’s disease are:

  • Ileocolitis: The most common type of Crohn’s, causing inflammation in the lower part of your small intestines and your large intestines.
  • Ileitis: Inflammation is limited to the lower part of your small intestines.
  • Jejunoileitis: Inflammation is limited to the middle part of your small intestines.
  • Granulomatous colitis: Inflammation is limited to your large intestines.

Read on to learn more about gastroduodenal Crohn’s disease, including its symptoms, treatment options, and outlook.

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Illustration showing where the duodenum is in the body, in reference to the surrounding GI tract. | Andrew Nguyen.

Many people with gastroduodenal Crohn’s disease don’t have any symptoms. When symptoms do appear, they can mimic those of a stomach ulcer.

The most common symptom is indigestion after eating. Some people also have:

More severe cases can cause:

Less than a third of people with Crohn’s only have gastroduodenal Crohn’s disease. Most people who don’t have Crohn’s in another part of their digestive tract develop it later.

Doctors are still largely unsure of why some people develop Crohn’s disease. It’s thought to occur when your immune system attacks healthy cells in your gastrointestinal tract. Bacteria in your gut may trigger this reaction.

Your genetics are thought to play a role in the development of Crohn’s. Research suggests that it’s linked to more than 200 genes. Environmental factors may also be a factor.

Gastroduodenal Crohn’s disease seems to affect males and females (sex assigned at birth) similarly with a reported rate of 1.2 to 1.

Risk factors for Crohn’s in general include:

Compared with other types of Crohn’s disease, gastroduodenal Crohn’s seems to affect younger people and people who don’t frequently smoke.

Gastrointestinal Crohn’s disease tends to have worse outcomes than other types of Crohn’s. The involvement of the stomach and upper small intestines is a risk factor for complications.

Potential complications include:

  • Stricture: Crohn’s disease can cause the walls of your intestines to thicken and block the passage of stool.
  • Fistulae: Fistulae are abnormal passages that can develop in the wall of your digestive tract.
  • Abscesses: An abscess is a painful infection filled with pus. They can form on inflamed parts of your digestive tract.
  • Malnutrition: Intestinal obstruction and dietary changes can lead to malnutrition.

Doctors use many different tests to diagnose Crohn’s, such as:

Gastroduodenal Crohn’s can be difficult to diagnose since colonoscopies and UGEs may have trouble reaching the inflamed part of your digestive tract. Doctors are more reliant on imaging techniques like CT enterography and MRI enterography, where you drink a liquid to make your digestive tract stand out on imaging.

Capsule endoscopy can help doctors visualize inflammation in your small intestines, but it isn’t performed if there’s a blockage in your intestines.

Learn more about testing for Crohn’s disease.

Treatment for gastroduodenal Crohn’s disease is usually the same as for Crohn’s in the lower part of your digestive tract. The main treatments are medication and surgery.

Home remedies

You may be able to help manage your symptoms at home by:

  • keeping a food diary and tracking foods that cause symptom flare-ups
  • drinking plenty of water and avoiding straws to minimize swallowing gas
  • eating small, frequent meals
  • meal prepping before leaving home
  • avoiding NSAIDs
  • quitting smoking if you smoke (this can be difficult, but a doctor can help build a cessation plan that works for you)
  • incorporating relaxing activities into your life, such as yoga
  • getting regular physical activity, such as exercising

Gastroduodenal Crohn’s disease diet

Making dietary changes may help minimize your symptoms. It’s often recommended to minimize or avoid eating:

  • high fiber foods
  • lactose
  • sugar
  • high fat foods
  • spicy foods
  • carbonated beverages

Your doctor may recommend bowel rest if your symptoms are severe. You may need to rest your bowel for days to weeks. Meanwhile, your doctor may recommend:

  • drinking a high nutrient liquid
  • receiving liquids through a feeding tube
  • starting intravenous (IV) nutrient therapy

Learn more about what to eat if you have Crohn’s.

Medical treatment

Medications can help reduce your symptoms. Common types of medications include:

  • corticosteroids, which help reduce disease inflammation
  • immunosuppressants, which help reduce immune system activity
  • biologics, which may be prescribed if other treatments are not working
  • biosimilars, which are medications that are highly similar to biologics that are already approved and may be prescribed if other treatments are not working
  • antacids, which help relieve stomach irritation

If medications are not effective, your doctor may recommend surgery to remove part of your gastrointestinal tract.

Many different surgeries can be performed, but the most common is called a gastrojejunostomy with a vagotomy. The procedure involves connecting your stomach to your mid-small intestines and cutting the nerve that tells your stomach to produce acid.

Surgery is also used to treat complications of Crohn’s, such as intestinal obstruction and fistulae.

It’s important to get medical attention if you notice potential signs and symptoms of Crohn’s disease, such as:

There are no known ways to prevent Crohn’s disease. Eating a Crohn’s-friendly diet, minimizing stress, and avoiding smoking may help you minimize flare-ups.

Gastroduodenal Crohn’s disease causes inflammation in your stomach and the upper part of your large intestines. Most people also have symptoms in their lower gastrointestinal tract or develop symptoms later.

Crohn’s involvement in your stomach or upper small intestines is often linked to less positive outcomes. Doctors primarily treat gastroduodenal Crohn’s with medications and surgery.