Variation in Prevalence, Diagnostic Criteria, and Initial Management Options for Eosinophilic Gastrointestinal Diseases in the United States

Spergel, Jonathan M.; Book, Wendy; Mays, Elizabeth; Song, L; Shah, Samir S.; Talley, Nicholas J.; Bonis, Peter A

doi:10.1097/mpg.0b013e3181eb5a9f

Cited by 247 publications

(195 citation statements)

References 41 publications

Supporting

Mentioning

173

Contrasting

Unclassified

Order By: Relevance

“…There is also a higher incidence of this disease in westernized countries and in urban areas of the United States with a significant Caucasian predominance of almost 90% [8,9] . More recent studies have updated the estimates of the incidence (7/100000) and prevalence (43/100000) of EoE [10] similar to the estimates reported from Olmsted County, Minnesota (incidence 9/100000; prevalence 55/100000) in patients identified retrospectively [11] . A similar prevalence estimate (52/100000) was derived from physician surveys.…”

Section: Prevalencesupporting

confidence: 51%

Eosinophilic esophagitis: New insights in pathogenesis and therapy

Guarino

Cicala

Behar

2016

WJGPT

View full text Add to dashboard Cite

Eosinophilic esophagitis (EoE) is a clinico-pathological entity with esophageal symptoms and dense esophageal eosinophilic infiltration throughout the esophagus that may persist despite treatment with proton pump inhibitors. This eosinophilic infiltration is usually absent in the stomach, small intestine and colon, although there are a number of reports of patients with a multiorgan involvement. EoE is associated with abnormalities involving TH2-dependent immunity, with multiple environmental factors strongly contributing to disease expression. The layer of the esophagus affected by the eosinophilic infiltration causes the specific symptoms. Esophageal involvement results mostly in dysphagia for solids that can be severe enough to cause recurrent esophageal obstruction with typical endoscopic features suggesting esophageal remodeling and pathological changes of eosinophilic infiltration of the mucosa, sub-epithelial fibrosis and muscle hypertrophy. This disease is frequently associated with other allergic conditions such as allergic asthma, allergic dermatitis and eosinophilia. The treatment of patients with EoE depends on the severity of the symptoms and of the inflammatory process as well as to their response to a gradual step-up treatment. The first line of treatment consists of steroid containing local inhalers. If unresponsive they are then treated with oral steroids. Intravenous interleukin blockers seem to have a consistent positive therapeutic effect. Core tip: Eosinophilic esophagitis is a clinico-pathological entity characterized by esophageal symptoms and dense esophageal eosinophilic infiltration throughout the esophagus. Our manuscript provides a deep description of the disease showing that many efforts have been made in the last decades in understanding REVIEWSubmit a

show abstract

Section: Prevalencesupporting

confidence: 51%

Eosinophilic esophagitis: New insights in pathogenesis and therapy

Guarino

Cicala

Behar

2016

WJGPT

View full text Add to dashboard Cite

show abstract

“…A survey administered to members of the American College of Gastroenterology in 2008 (with a response rate of 17%) revealed an estimated prevalence rate of 52 patients with EoE per 100,000 inhabitants [17]. In a national pathology database (Caris Diagnostics, Irving, Tex., USA), 363 cases of EoE from a cohort of upper endoscopies were identified in more than 74,000 upper endoscopies.…”

Section: Incidence and Prevalence Of Eoe Based On Endoscopy And Histomentioning

confidence: 99%

Epidemiology of Eosinophilic Esophagitis

Hrúz¹

2014

Dig Dis

View full text Add to dashboard Cite

Eosinophilic esophagitis (EoE) is an allergy-associated disease defined clinically by esophagus-related symptoms in combination with a dense esophageal eosinophilia, both of which are unresponsive to prolonged acid suppression with proton pump inhibitors. Over the last two decades EoE has increasingly been recognized in various geographical areas (mostly industrialized countries) with high socioeconomic development. The prevalence rate is increasing and reaches up to 50 patients per 100,000 inhabitants in some indicator regions. Whether this increased prevalence is due to a real increase in incidence, a result of increased awareness by health care providers or because of the nonfatal nature of EoE adding more and more cases to the patient pool is still a matter of controversy. Several studies have consistently demonstrated a male predominance in EoE, with a male-to-female risk ratio of 3:1. The average age at diagnosis ranges between 30 and 50 years and suggests that EoE is a disease of the middle-aged man. It can affect patients of every race, but the disease is more common among Caucasians. In both children and adults, EoE has been clearly associated with allergies to food and aeroallergens, and most EoE patients present with a personal allergic background (e.g. asthma, rhinoconjunctivitis or oral allergy syndrome). In conclusion, knowledge of epidemiologic parameters of EoE is crucial for identifying risk factors as well as pathogenic mechanisms, planning preventive measures and determining optimal treatment strategies.

show abstract

“…[1] There is evidence that EoE incidence increased over the last decades with current prevalence rates in the Unites States and Europe of about 1 affected individual among 2,000 inhabitants in the pediatric as well as in the adult population. [2][3][4][5][6] Adult EoE patients primarily suffer from dysphagia, often culminating in food impaction necessitating endoscopic bolus removal. [7][8][9] The endoscopic presentation of EoE is quite variable.…”

Section: Introductionmentioning

confidence: 99%