The prevalence of eosinophilic esophagitisin patients who had esophageal or upper gastrointestinal symptoms

Abstract

Background Prevalence of eosinophilic esophagitis (EoE) has been reported variably according to the subject and definition. We evaluated prevalence of EoE among patients who had esophageal or upper gastrointestinal (UGI) symptoms.

Methods Patients who had seven esophageal or UGI symptoms (dysphagia, food impaction, acid regurgitation, heartburn, chest pain, epigastric pain and nausea and/or vomiting) for more than once a week were prospectively collected from Jan. to Oct. 2009. All responded to symptomatic questionnaire, underwent gastroduodenoendoscopy and esophageal biopsies (three pieces from distal esophagus, two from middle). Typical endoscopic findings of EoE (ring-like appearance, liner furrow, whitish papule, shearing or friability) were recorded. EoE was diagnosed if esophageal biopsy showed ≥20 eosinophils/high power field.

Results One hundred and twenty-two patients (male:female 63:59, mean age 47.2 years) were enrolled and typical endoscopic findings were found in 31 (25.4%) patients (whitish papule: 19 [15.4%], ring-like appearance: 8 [6.5%], linear furrow: 5 [4.1%]). EoE was diagnosed in 8 (6.6%) patients, and typical endoscopic findings and past history of gastroesophageal reflux disorder, allergic rhinitis, atopy were significantly more common in EoE (+) patients than EoE (−). Diagnostic yield of typical endoscopic findings were 40.0% (2/5 patients) in linear furrow, 25.0% (2/8) in ring-like appearance and 15.8% (3/19) in whitish papule. Most bothersome symptoms among EoE patients were acid regurgitation (3/7, 42.9%), food impaction (2/7, 28.6%), dysphagia and epigastric pain (1/7, 14.3% respectively).

Conclusion Prevalence of EoE among patients with esophageal or UGI symptoms were 6.6% in Korea. Linear furrow and ring-like appearance showed relatively higher diagnostic value.