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Prevalence of Eosinophilic Esophagitis among Patients Presenting with Dysphagia to a Community Gastroenterology Practice

35

Zink, David A., M.D.; Tosch, Kimberly, M.D.; Chang, C., M.D.; Desai, Tusar K., M.D.

American Journal of Gastroenterology: September 2005 - Volume 100 - Issue - p S34
Supplement Abstracts Submitted for the 70th Annual Scientific Meeting of the American College of Gastroenterology: ESOPHAGUS
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Division of Gastroenterology and Hepatology, William Beaumont Hospital, Royal Oak, MI and Department of Pathology, William Beaumont Hospital, Royal Oak, MI.

Purpose: Dysphagia is a common symptom of eosinophilic esophagitis (EE). No reports exist regarding the prevalence of EE in patients presenting with dysphagia. The aim of our study was to assess the prevalence of (EE) among patients presenting with dysphagia to a community gastroenterology group.

Methods: Clinical, endoscopic, histologic and radiologic records were reviewed from a consecutive series of patients presenting with undiagnosed solid food dysphagia to a community-based gastroenterologist. EE was defined as more than 20 eosinophils/hpf in esophageal biopsies. Esophageal motility disorders were diagnosed by barium esophagram and/or esophageal manometry and/or scintigraphy. Patients with a documented history of esophageal food impaction, malignancy, HIV infection, dementia and oro-pharyngeal dysphagia were excluded.

Results: Over a 2-year period 95 patients (42 men and 53 women) who met study criteria were evaluated for dysphagia (Table 1). We diagnosed EE in 15 patients (12 men and 3 women). All patients diagnosed with EE had been treated with proton pump inhibitors for at least 10 days prior to diagnosis. Seven of the subjects had both a Schatzki ring and EE. Barrett's esophagus was an uncommon finding in patients with dysphagia (n = 5).

Table 1

Table 1

Conclusions: We found EE in approximately 16% of patients presenting with solid food dysphagia. It is particularly common among patients under age 60. A high index of suspicion for EE should be maintained when evaluating causes of dysphagia.

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