An Update on Intestinal Behcet's Disease
An Update on Intestinal Behcet's Disease
Gastrointestinal involvement in Behçet's disease is 0–60%, occurring more commonly in East Asia than in Mediterranean areas. The lesions can be found throughout the gastrointestinal tract (from the lips to the anus), but are most common in the ileocecal region. Esophagogastroduodenal involvement is very rare and nonspecific. The gastrointestinal manifestations usually appear 4.5–6 years after the onset of oral ulcers; however, they can also appear before the onset of any other Behçet's disease symptoms. Involvement of the entire gastrointestinal tract is extremely uncommon, but leads to severe complications.
Symptoms of intestinal Behçet's disease range from mild abdominal discomfort to severe pain, and patients can present either with or without further complications such as bleeding, fistula, or perforation. Abdominal pain associated either with or without diarrhea, bleeding, vomiting, bowel habit change, or weight loss is most commonly observed. Hemorrhage or bowel perforation can be life-threatening in some cases. Because symptoms overlap with clinical manifestations of intestinal infectious diseases such as tuberculosis, or inflammatory bowel diseases such as ulcerative colitis or Crohn's disease, a thorough follow-up examination of the patient is essential.
Clinical Manifestations
Gastrointestinal involvement in Behçet's disease is 0–60%, occurring more commonly in East Asia than in Mediterranean areas. The lesions can be found throughout the gastrointestinal tract (from the lips to the anus), but are most common in the ileocecal region. Esophagogastroduodenal involvement is very rare and nonspecific. The gastrointestinal manifestations usually appear 4.5–6 years after the onset of oral ulcers; however, they can also appear before the onset of any other Behçet's disease symptoms. Involvement of the entire gastrointestinal tract is extremely uncommon, but leads to severe complications.
Symptoms of intestinal Behçet's disease range from mild abdominal discomfort to severe pain, and patients can present either with or without further complications such as bleeding, fistula, or perforation. Abdominal pain associated either with or without diarrhea, bleeding, vomiting, bowel habit change, or weight loss is most commonly observed. Hemorrhage or bowel perforation can be life-threatening in some cases. Because symptoms overlap with clinical manifestations of intestinal infectious diseases such as tuberculosis, or inflammatory bowel diseases such as ulcerative colitis or Crohn's disease, a thorough follow-up examination of the patient is essential.