There is disagreement as to whether OFG represents an early form of Crohn's disease or sarcoidosis, or whether it is a distinct, but similar clinical entity.

[3][6][9] Some suggest that infection with atypical mycobacteria could be involved, (paratuberculosis),[3] and that OFG is a reaction to mycobacterial stress protein mSP65 acting as an antigen.

[3] The diagnosis is usually made by tissue biopsy, however this cannot reliably distinguish between the granulomas of OFG and those of Crohn disease or sarcoidosis.

[8] Other causes of granulomatous inflammation are ruled out, such as sarcoidosis, Crohn disease, allergic or foreign body reactions and mycobacterial infections.

Anti-tumour necrosis factor α drugs (e.g. infliximab) [10] Dietary restriction of a particular suspected or proven antigen may be involved in the management of OFG, such as cinnamon or benzoate-free diets.