The Gastro-intestinal tract

It is probable that in a proportion of patients in the active stage of sarcoidosis granulomas are present in the gastro-intestinal tract without causing symptoms, but this proportion is unknown. Infiltration causing symptoms because of its extent or local severity is rare. Among recorded cases which can be accepted as sarcoidosis of the alimentary tract causing symptoms, the majority have involved the stomach. If the gut is the principal or the only clinically evident site of granulomatous disease, unequivocal diagnostic categorization may be difficult or impossible. In the small gut, a special difficulty arises in relation to Crohn’s disease, because of the granulomatous component in the histopathology of many cases and of some immunological features which it shares with sarcoidosis.