Literature DB >> 18624788

Eosinophilic oesophagitis in patients presenting with dysphagia--a prospective analysis.

S H Mackenzie1, M Go, B Chadwick, K Thomas, J Fang, S Kuwada, S Lamphier, K Hilden, K Peterson.   

Abstract

BACKGROUND: Eosinophilic oesophagitis (EoO) may be a common finding in adults presenting with dysphagia. AIM: To identify the risk factors and prevalence of EoO in an adult population with dysphagia.
METHODS: All patients with dysphagia referred for an upper endoscopy (EGD) were asked to participate. Patients completed a detailed questionnaire followed by EGD with four quadrant biopsies in the distal and mid-oesophagus. Primary endpoint was the prevalence of EoO; secondary endpoints included age, gender, asthma, food allergies, gastro-oesophageal reflux disease/dysphagia score and endoscopic findings.
RESULTS: Two hundred and sixty-one patients enrolled between December 2005 and January 2007. Thirty-one patients (12%) met pathological criteria for EoO. There was no difference in EoO prevalence within each gender. Mean age of EoO patients was 42 +/- 15 vs. 61 +/- 15 for non-EoO patients (P < 0.001). EoO was diagnosed in 35% of patients <50 years of age. EoO was present in 22% of asthmatics vs. 9% non-asthmatics (P < 0.01). EoO was present in 36.8% of patients with self-reported food allergies vs. 9.3% those without allergy (P < 0.001). A 13/31(42%) of EoO patients did not have the classic EGD findings (rings +/- furrows) and would have been missed without oesophageal biopsies.
CONCLUSIONS: Eosinophilic oesophagitis was diagnosed in 12% of the patients presenting with dysphagia with relative risk of 9.5 if age <50 years. Oesophageal biopsies are warranted in patients presenting with dysphagia especially in the younger population. Patients may not present with classic endoscopic findings and EoO can be missed without biopsies.

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Year:  2008        PMID: 18624788     DOI: 10.1111/j.1365-2036.2008.03795.x

Source DB:  PubMed          Journal:  Aliment Pharmacol Ther        ISSN: 0269-2813            Impact factor:   8.171


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