Relationship Between Housing Components and Development of Eosinophilic Esophagitis

Corder, S.R.; Tappata, Manaswita; Shaheen, Olivia; Cotton, Cary C.; Jensen, Elizabeth T.; Dellon, Evan S.

doi:10.1007/s10620-020-06063-2

Cited by 14 publications

(11 citation statements)

References 39 publications

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“…Corder et al described association between EoE diagnosis and houses of brick exterior, forced air or gas heating. 17 We examined the role of medical insurance and socioeconomic status using patients' neighborhood adjusted gross income as a surrogate of household income. There was no difference in EFI risk across ve different levels of household income.…”

Section: Discussionmentioning

confidence: 99%

The Risk of Esophageal Food Impaction In Eosinophilic Esophagitis Patients; The Role of Clinical And Socioeconomic Factors

Alhmoud

Ghazaleh

Ghanim

et al. 2022

Preprint

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Background: 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: 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: 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. 48 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) = .28, 95%CI (0.11, 0.72) [P = .008]. Females had less EFI risk; OR = 0.42, 95%CI (0.19, 0.95) [P = .04]. The type of medical insurance and socioeconomic status was not associated with EFI risk.Conclusion: 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.

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Section: Discussionmentioning

confidence: 99%

The Risk of Esophageal Food Impaction In Eosinophilic Esophagitis Patients; The Role of Clinical And Socioeconomic Factors

Alhmoud

Ghazaleh

Ghanim

et al. 2022

Preprint

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“…This was a retrospective cohort study of the University of North Carolina (UNC) EoE Clinicopathologic Database between 2002 and 2018. The development and characteristics of the database have been previously reported [13][14][15][16][17][18][19] with any one of these endoscopic findings were categorized as having an abnormal endoscopic appearance. When available after its introduction, EREFS scores were also extracted, using the standard scoring (edema 0-1, rings 0-3, exudates 0-2, furrows 0-2, stricture 0-1 with diameter recorded).…”

Section: Methodsmentioning

confidence: 99%

Clinical features and time trends associated with an endoscopically normal esophagus in active eosinophilic esophagitis

et al. 2020

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Background and Aims: A proportion of patients with active eosinophilic esophagitis (EoE) have a normal appearing esophagus on endoscopy (EGD). We aimed to determine associations between baseline clinical features and the endoscopically normal esophagus in EoE as well as time trends in reporting. Methods: In this retrospective study of active EoE cases from 2002-2018, patients with and without esophageal endoscopic abnormalities were compared. Multivariable logistic regression identified independent predictors of a normal EGD. The proportion of patients with a normal EGD was determined per year and before and after introduction of the first EoE guidelines and EoE Endoscopic Reference Score (EREFS). Results: Of 878 EoE patients, 101 (11.5%) had an endoscopically normal esophagus. They were younger (8.3 vs. 25.4 years), had shorter symptom duration before diagnosis (median 2.8 vs. 5.0 yrs), less likely to have dysphagia (40% vs. 76%) and food impaction (8% vs. 33%), and more likely to have abdominal pain (37% vs. 19%) (p<0.01 for all). On multivariable logistic regression, independent predictors of a normal esophagus were younger age (OR=0.96, 95% CI:0.94-0.98), abdominal pain (OR=2.03, 1.13-3.67), and lack of dysphagia (OR=0.49, 0.26-0.93). The proportion of patients with a normal esophagus decreased from 21% before the first EoE guidelines to 7% (p<0.01) after introduction of EREFS. Conclusions: An endoscopically normal esophagus is seen in ~10% of active EoE patients and should not preclude biopsies. Younger age, abdominal pain, and lack of dysphagia are independent predictors. The proportion of normal EGDs decreased over time, suggesting improved recognition of endoscopic findings.

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“…Many factors influence the development of EoE, including environmental factors, such as climate, geography, population density, housing materials, and water and air quality, and prenatal and early life factors, particularly those associated with gut colonization and dysbiosis, and atopic disease in childhood (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35).…”

Section: Eoe Prevalence and Etiologymentioning

confidence: 99%

Disease Burden and Unmet Need in Eosinophilic Esophagitis

et al. 2022

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Eosinophilic esophagitis (EoE) is a chronic, progressive, type 2 inflammatory disease of increasing prevalence, characterized by symptoms of dysphagia and reduced quality of life. A dysregulated type 2 immune response to food and aeroallergen leads to barrier dysfunction, chronic esophageal inflammation, remodeling, and fibrosis. Patients with EoE have impaired quality of life because of dysphagia and other symptoms. They may also suffer social and psychological implications of food-related illness and expensive out-of-pocket costs associated with treatment. Disease burden in EoE is often compounded by the presence of comorbid type 2 inflammatory diseases. Current conventional treatments include elimination diet, proton pump inhibitors, and swallowed topical corticosteroids, as well as esophageal dilation in patients who have developed strictures. These treatments demonstrate variable response rates and may not always provide long-term disease control. There is an unmet need for long-term histologic, endoscopic, and symptomatic disease control; for targeted therapies that can normalize the immune response to triggers, reduce chronic inflammation, and limit or prevent remodeling and fibrosis; and for earlier diagnosis, defined treatment outcomes, and a greater understanding of patient perspectives on treatment. In addition, healthcare professionals need a better understanding of the patient perspective on disease burden, the disconnect between symptoms and disease activity, and the progressive nature of EoE and the need for continuous monitoring and maintenance treatment. In this review, we explore the progression of disease over the patient's lifespan, highlight the patient perspective on disease, and discuss the unmet need for effective long-term treatments.

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Relationship Between Housing Components and Development of Eosinophilic Esophagitis

Cited by 14 publications

References 39 publications

The Risk of Esophageal Food Impaction In Eosinophilic Esophagitis Patients; The Role of Clinical And Socioeconomic Factors

The Risk of Esophageal Food Impaction In Eosinophilic Esophagitis Patients; The Role of Clinical And Socioeconomic Factors

Clinical features and time trends associated with an endoscopically normal esophagus in active eosinophilic esophagitis

Disease Burden and Unmet Need in Eosinophilic Esophagitis

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