Prevalence of Eosinophilic Esophagitis in an Adult Population Undergoing Upper Endoscopy: A Prospective Study

Veerappan, Ganesh R.; Perry, Joseph L.; Duncan, Timothy J.; Baker, Thomas P.; Maydonovitch, Corinne; Lake, Jason M.; Wong, Roy K.H.; Osgard, Eric M.

doi:10.1016/j.cgh.2008.10.009

Cited by 232 publications

(248 citation statements)

References 29 publications

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“…Estimated overall prevalence in general population is between 40 and 90/100,000 persons in most studies from America, Australia and Europe [10][11][12][13][14][15][16][17] The prevalence of EoE in those who undergo upper endoscopy highly depends on the indication. The overall prevalence for any indication ranges from 2.4% up to 6.6% [18][19][20]. If the indication is dysphagia then the prevalence is up to 23% [21][22][23], and this rate rises up to 63% if an urgent endoscopy for food bolus impaction is performed [24,25].…”

Section: Epidemiologymentioning

confidence: 99%

Eosinophilic Esophagitis- Clinical Management in Adults

Georgios¹,

Stergios²,

Erminia³

2014

J Gastroint Dig Syst

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Eosinophilic esophagitis (EoE) represents a chronic, immune-mediated esophageal disease, characterized clinically by symptoms related to esophageal dysfunction, histologically by eosinophilic infiltration of esophageal mucosa and endoscopically by a range of abnormalities. EoE is increasing in prevalence and predominantly affects children and young males, with a racial predilection of the patients being Caucasian. The relationship between EoE and gastroesophageal reflux disease (GERD) can be complex, since their clinical and pathologic features may overlap. Furthermore, an entity that can be considered a subtype of GERD or EoE is the proton pump inhibitorresponsive esophageal eosinophilia (PPI-REE). PPI-REE emerged from the observation that some patients who appeared to have EoE would have a clinical and histologic response to PPI treatment. Currently, upper endoscopy with esophageal biopsies is the only way to diagnose EoE. Fifteen eosinophils//high-power field (hpf) are considered a minimum threshold for the diagnosis of EoE, since the disease is isolated to the esophagus and other causes of esophageal eosinophilia are excluded. Patients commonly have concurrent allergic diatheses, especially to food. The therapeutic options of EoE include: chronic elimination diet, topical corticosteroids and esophageal dilation. We review the latest approach to clinical diagnosis and management of EoE.

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Section: Epidemiologymentioning

confidence: 99%

Eosinophilic Esophagitis- Clinical Management in Adults

Georgios¹,

Stergios²,

Erminia³

2014

J Gastroint Dig Syst

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“…43,44 Other features include history of sudden onset food impaction, 45,46 chest pain and heartburn. 47 However the symptoms of EoE are very nonspecific and no symptom in isolation points towards the diagnosis of EoE. Approximately 60 -80% children and fewer adults have a history of associated allergic diseases such as asthma, atopic dermatitis, atopic rhinitis and food allergies.…”

Section: Clinical Featuresmentioning

confidence: 99%

Eosinophilic esophagitis

Kedia¹

2015

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Eosinophilic esophagitis (EoE) is a clinico-pathological entity characterised by symptoms of esophageal dysfunction and eosinophilia on esophageal mucosal biopsies in the absence of other causes of esophageal eosinophilia. It is a chronic inflammatory condition of esophagus often characterized by refractory reflux symptoms in children and dysphagia in adults. It occurs as a result of Th2 inflammatory response to environmental triggers (food antigens) in genetically predisposed individuals. The diagnostic criteria include symptoms of esophageal dysfunction, esophageal eosinophilia (> 15/hpf), and a PPI trial (persistent eosinophilia after 8 weeks of PPI). Mainstay of treatment at present is topical steroids and dietary therapy.Maintenance treatment should be considered to prevent long term complications.

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“…Endoscopic findings suggestive of EoE (e.g. rings, furrows or plaques) have a high specificity (approaching 90%) even though sensitivity may be low [37] . Two to four biopsy specimens from both the distal and proximal oesophagus should be obtained [1] .…”

Section: Endoscopic Appearancesmentioning

confidence: 99%