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Prevalence of eosinophilic esophagitis in patients with refractory gastroesophageal reflux disease symptoms: A prospective study. | LitMetric

AI Article Synopsis

  • - Eosinophilic esophagitis (EoE) is rarely considered when diagnosing patients with persistent gastroesophageal reflux disease (GERD) symptoms that don't respond to treatment.
  • - In a study of 150 patients with refractory GERD, only 4% were diagnosed with EoE, and those individuals tended to be younger and exhibited additional symptoms like swallowing difficulties and allergic conditions.
  • - Key indicators for suspecting EoE in patients with persistent GERD include age under 45, the presence of dysphagia, and a history of allergic conditions (atopy).

Article Abstract

Background: Eosinophilic esophagitis (EoE) is not routinely considered in the differential diagnosis of refractory gastroesophageal reflux disease (GERD).

Aims: To prospectively evaluate the prevalence of EoE and describe the clinical features and predictors of EoE in patients with refractory symptoms of GERD.

Methods: Esophageal biopsies were obtained in patients with symptoms of GERD refractory to 8 weeks of conventional antisecretory therapy. Diagnosis of EoE was defined as at least 20 eosinophils × high power field and clinical unresponsiveness to proton pump inhibitors. Clinical and manometric features were compared. Independent risk factors predicting EoE were identified.

Results: Six out of 150 included patients (4%) met the diagnostic criteria for EoE. Patients with EoE were significantly younger, had significantly more dysphagia, atopy, ineffective esophageal peristalsis, esophageal rings and esophageal strictures than patients without EoE. Independent predictors of EoE were: age under 45 years (OR 4.8, 95% CI 2.4-8.6), dysphagia (OR 12.2, 95% CI 4.3-19.4), and atopy (OR 3.4, 95% CI 1.5-7.4).

Conclusions: EoE is an uncommon condition (4%) in patients with refractory symptoms of GERD. Age under 45 years, atopy or dysphagia may warrant suspicion of EoE in this subset of patients.

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Source
http://dx.doi.org/10.1016/j.dld.2010.08.002DOI Listing

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