Eosinophilic Esophagitis among Patients with Refractory Gastroesophageal Reflux Disease

Abstract

Background: Eosinophilic esophagitis (EoE) may be linked to gastroesophageal reflux disease (GERD) in as many as 30% of patients of EoE. The aim is to study the prevalence and clinical presentation of Eosinophilic esophagitis among patients with refractory GERD. Methods: This cross-sectional study was conducted on 181 patients presented with persistent GERD symptoms despite double dose PPI therapy for at least 8 weeks without interruption, who were referred to gastroenterology unit of Internal Medicine Department at Benha University Hospitals. All patients were subjected to proper and detailed history taking and thorough clinical examination, laboratory investigations including complete blood count with differential leucocytic count and upper gastrointestinal endoscopy and biopsy for histopathological examination. Results: The mean age of the patients was 36.7±11.46 years. One hundred and three (56.9%) patients were males and 78 (43.1%) were females. Among the studied cases, 9 (5.0%) cases had EoE and 2 (1.1%) cases had eosinophilic gastroenteritis. Peripheral eosinophilia was found in 6 (66.7%) of EoE cases. EoE cases had statistically significant higher incidence of atopy, dysphagia, food impaction, furrows, white plaques, concentric rings and strictures compared to refractory GERD patients without EoE (P<0.05). Conclusions: Our results showed that 5% of patients with refractory GERD had EoE. EoE cases had significantly higher association with history of atopy. Most patients with EoE presented with dysphagia and food impaction. Endoscopic features of EoE patients included furrows, white plaques, strictures and concentric rings. EoE cases have higher incidence of having peripheral eosinophilia at their CBCs.