Oesophageal baseline impedance values are decreased in patients with eosinophilic oesophagitis

Abstract

Background: Gastro-oesophageal reflux has been suggested to play a role in eosinophilic oesophagitis (EoO). Oesophageal acid exposure decreases baseline intraluminal impedance, a marker of mucosal integrity, in patients with gastro-oesophageal reflux disease (GORD). Objectives: The aim of this study was to assess oesophageal baseline impedance levels in EoO patients and to investigate their relationship with oesophageal acid exposure. Methods: Ambulatory 24-h pH-impedance monitoring was performed in 11 EoO patients and in 11 healthy controls with matched oesophageal acid exposure. We assessed baseline impedance levels in the distal, mid-, and proximal oesophageal impedance channels.

Histological Response to Fluticasone Propionate in Patients With Eosinophilic Esophagitis Is Associated With Improved Functional Esophageal Mucosal Integrity

“…In that study, we observed that in patients with PPI-REE histological response to PPI treatment was associated with improvement of the esophageal mucosal barrier integrity. In EoE patients, PPIs do not aff ect esophageal mucosal integrity, which perhaps is not surprising because by defi nition those who respond to PPIs are not diagnosed with EoE ( 10,23 ). However, similar to the eff ect of PPIs in patients with PPI-REE, we now found that improvement of the esophageal mucosal barrier integrity in response to fl uticasone propionate treatment paralleled the decrease of esophageal infl ammation.…”

PPI-responsive esophageal eosinophilia cannot be distinguished from eosinophilic esophagitis by endoscopic signs

“…Several mechanisms have been suggested as an explanation for the considerable response to PPI. This suggests that acid reflux may play a potentiating role in the increased permeability of the esophageal mucosa, facilitating transepithelial allergen flux in PPI-REE [23]. Esophageal eosinophil infiltration in EoE may be because of acid reflux as it has been shown that acid exposure can contribute toward an increased esophageal permeability because of mucosal damage [22].…”

Interactions between gastro-oesophageal reflux disease and eosinophilic oesophagitis

“…Baseline impedance values were markedly lower in EoE patients along the entire length of the oesophagus, not only in distal oesophagus, when compared to matched healthy controls [50]. Of note, impedance values in EoE did not correlate with acid exposure or the number or reflux episodes [50].…”