Predictors of recurrent esophageal food impaction: a case-control study

• Published in: Journal of clinical gastroenterology Vol. 42; no. 7; p. 771
• Main Authors: Prasad, Ganapathy A, Reddy, Jagadeshwar G, Boyd-Enders, Felicity T, Schmoll, Jeffrey A, Lewis, Jason T, Wongkeesong, Louis-Michel
• Format: Journal Article
• Language: English
• Published: United States 01.08.2008
• Subjects: Adult; Aged; Aged, 80 and over; Case-Control Studies; Esophageal Stenosis - complications; Esophagitis - complications; Esophagoscopy - adverse effects; Esophagus; Female; Food; Foreign Bodies; Hernia, Hiatal - complications; Humans; Male; Meat; Middle Aged; Recurrence; Risk Factors
• ISSN: 1539-2031
• DOI: 10.1097/MCG.0b013e31815576d2

Esophageal food impaction (FI) is a distressing condition requiring urgent endoscopic intervention, with a reported recurrence rate between 10% and 20%. Knowledge of factors predisposing to recurrent FI may enable preventive measures to minimize the risk of recurrence. To identify risk factors associated with recurrent FI. Retrospective case-control study. Tertiary referral center. A prospectively maintained database and medical records of all patients undergoing emergent endoscopy for FI from 1989 to 2000 were reviewed. Cases were defined as those presenting with more than 1 episode of FI, whereas controls were defined as those without recurrence within 5 years of the index episode. Several demographic, clinical, endoscopic, and follow-up variables were extracted. Statistical analysis included chi2 tests and t tests for univariate analysis, and stepwise logistic regression for multivariate analysis. NA. Predictors of recurrent FI. A total of 52 cases and 124 controls were identified (recurrence rate 30%). Presence of a diaphragmatic hernia [odds ratio (OR) 2.65; confidence interval (CI) 1.19-5.89], disimpaction by piecemeal extraction (OR 2.32; CI 1.09-4.97), and acquisition of esophageal biopsies (OR 3.69; CI 1.42-9.66) increased odds for recurrent FI. Physician follow-up after FI decreased the odds for recurrent FI (OR 0.38; CI 0.18-0.80). Retrospective study. The presence of a diaphragmatic hernia, complexity of endoscopic disimpaction technique, and lack of follow-up increased risk for recurrent FI. Collection of esophageal biopsies as a risk factor suggests a visibly more severe esophageal disorder as a potential cause for recurrent FI.