The Risk of Esophageal Food Impaction in Eosinophilic Esophagitis Patients: The Role of Clinical and Socioeconomic Factors.
eosinophilic esophagitis
felinization
food impaction
gastroesophageal reflux disease
linear furrows
Journal
Clinical and experimental gastroenterology
ISSN: 1178-7023
Titre abrégé: Clin Exp Gastroenterol
Pays: New Zealand
ID NLM: 101532800
Informations de publication
Date de publication:
2022
2022
Historique:
received:
04
03
2022
accepted:
22
08
2022
entrez:
22
9
2022
pubmed:
23
9
2022
medline:
23
9
2022
Statut:
epublish
Résumé
Eosinophilic esophagitis (EoE) patients present with dysphagia and often suffer from esophageal food impaction (EFI). EFI can lead to life-threatening perforation, and requires emergent endoscopic intervention. The aim of this study is to evaluate the risk factors for EFI in EoE patients. This is a retrospective study performed at a tertiary health-care system. Medical records and endoscopy images of EoE cases were reviewed. Clinical characteristics and outcomes including EFIs were documented. We used Zip-code median household income as a surrogate for patients' socioeconomic status. A total of 291 EoE cases were included, mean age was 42 years. Most patients (65%) had classic EoE endoscopic findings including linear furrows and/or concentric rings; however, a significant proportion (47%) had findings suggestive of gastroesophageal reflux disease (GERD), such as the presence of erosive-esophagitis, a hiatal hernia or Schatzki's ring. Forty-eight patients (16%) developed one or more esophageal food impaction (EFI). The risk of EFI was less likely in the absence of furrows and/or rings; odds ratio (OR) = 0.28, 95% CI (0.11, 0.72) [P = 0.008]. Females had less EFI risk; OR = 0.42, 95% CI (0.19, 0.95) [P = 0.04]. The type of medical insurance and socioeconomic status was not associated with EFI risk. EFI risk is higher in EoE patients with esophageal furrows and/or rings and in men. Aggressive treatment might be required in this population. GERD and EoE can coexist in many patients. Further studies are required to examine the role of the socioeconomic status in EoE complications.
Sections du résumé
Background
UNASSIGNED
Eosinophilic esophagitis (EoE) patients present with dysphagia and often suffer from esophageal food impaction (EFI). EFI can lead to life-threatening perforation, and requires emergent endoscopic intervention. The aim of this study is to evaluate the risk factors for EFI in EoE patients.
Methods
UNASSIGNED
This is a retrospective study performed at a tertiary health-care system. Medical records and endoscopy images of EoE cases were reviewed. Clinical characteristics and outcomes including EFIs were documented. We used Zip-code median household income as a surrogate for patients' socioeconomic status.
Results
UNASSIGNED
A total of 291 EoE cases were included, mean age was 42 years. Most patients (65%) had classic EoE endoscopic findings including linear furrows and/or concentric rings; however, a significant proportion (47%) had findings suggestive of gastroesophageal reflux disease (GERD), such as the presence of erosive-esophagitis, a hiatal hernia or Schatzki's ring. Forty-eight patients (16%) developed one or more esophageal food impaction (EFI). The risk of EFI was less likely in the absence of furrows and/or rings; odds ratio (OR) = 0.28, 95% CI (0.11, 0.72) [P = 0.008]. Females had less EFI risk; OR = 0.42, 95% CI (0.19, 0.95) [P = 0.04]. The type of medical insurance and socioeconomic status was not associated with EFI risk.
Conclusion
UNASSIGNED
EFI risk is higher in EoE patients with esophageal furrows and/or rings and in men. Aggressive treatment might be required in this population. GERD and EoE can coexist in many patients. Further studies are required to examine the role of the socioeconomic status in EoE complications.
Identifiants
pubmed: 36132486
doi: 10.2147/CEG.S364994
pii: 364994
pmc: PMC9484774
doi:
Types de publication
Journal Article
Langues
eng
Pagination
153-161Informations de copyright
© 2022 Alhmoud et al.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest in this work.
Références
J Allergy Clin Immunol. 2018 Jul;142(1):32-40
pubmed: 29729305
Dig Dis Sci. 2020 Dec;65(12):3624-3630
pubmed: 31970609
Gut. 2014 Jun;63(6):871-80
pubmed: 23853213
Dis Esophagus. 2019 Apr 1;32(4):
pubmed: 30295715
Schweiz Med Wochenschr. 1994 Aug 20;124(33):1419-29
pubmed: 7939509
Pediatr Radiol. 2012 Dec;42(12):1437-40
pubmed: 22886377
N Engl J Med. 2015 Oct 22;373(17):1640-8
pubmed: 26488694
Gastroenterology. 2018 Oct;155(4):1022-1033.e10
pubmed: 30009819
United European Gastroenterol J. 2019 May;7(4):548-556
pubmed: 31065372
Gastroenterol Clin North Am. 2014 Jun;43(2):201-18
pubmed: 24813510
Curr Opin Gastroenterol. 2015 Jul;31(4):309-15
pubmed: 26039722
Otolaryngol Head Neck Surg. 2018 Oct;159(4):750-754
pubmed: 29807494
Adv Respir Med. 2017;85(2):97-108
pubmed: 28440535
Clin Gastroenterol Hepatol. 2012 Sep;10(9):988-96.e5
pubmed: 22610003
Ann Allergy Asthma Immunol. 2019 Jan;122(1):65-72.e1
pubmed: 30223114
AJR Am J Roentgenol. 1981 May;136(5):1001-3
pubmed: 6784497
J Allergy Clin Immunol. 2011 Jul;128(1):3-20.e6; quiz 21-2
pubmed: 21477849
Am J Gastroenterol. 2018 Jun;113(6):836-844
pubmed: 29700481
Cancers (Basel). 2021 Mar 24;13(7):
pubmed: 33805136
Aliment Pharmacol Ther. 2019 May;49(9):1116-1125
pubmed: 30887555
Dig Dis Sci. 1993 Jan;38(1):109-16
pubmed: 8420741
Gastroenterology. 2018 Jan;154(2):319-332.e3
pubmed: 28774845
Mayo Clin Proc. 2019 Jan;94(1):44-53
pubmed: 30611453
J Clin Gastroenterol. 2017 Oct;51(9):805-813
pubmed: 27680593
World J Gastroenterol. 2012 Dec 21;18(47):6960-6
pubmed: 23322994