THE SLENDER ESOPHAGUS: UNRECOGNIZED ESOPHAGEAL NARROWING IN EOSINOPHILIC ESOPHAGITIS

Abstract

Abstarct 

BACKGROUND: 

Inflammation in eosinophilic esophagitis (EoE) often leads to esophageal strictures. Evaluating esophageal narrowing is clinically challenging. We evaluated esophageal distensibility as related to disease activity, fibrosis, and dysphagia.

METHODS: 

Adult patients with and without EoE underwent endoscopy and distensibility measurements. Histology, distensibility, and symptoms were analyzed.

RESULTS: 

EoE subjects had significantly lower distensibilities than controls. We found a cohort with esophageal diameter under 15mm despite lack of dysphagia.

CONCLUSIONS: 

This study raises concern that current assessments of fibrostenosis are suboptimal. We describe a cohort with unrecognized slender esophagus that were identified via impedance planimetry measurements. This tool provides additional information beyond symptomatic, histologic and endoscopic assessments.