Eosinophilic Esophagitis in Patients with Refractory Gastroesophageal Reflux Disease

• Published in: Digestive diseases and sciences Vol. 55; no. 1; pp. 28 - 31
• Main Authors: Foroutan, Mojgan, Norouzi, Alireza, Molaei, Mahsa, Mirbagheri, Seyed Amir, Irvani, Shahrokh, Sadeghi, Amir, Derakhshan, Faramarz, Tavassoli, Samaneh, Besharat, Sima, Zali, Mohammadreza
• Format: Journal Article
• Language: English
• Published: Boston Boston : Springer US 2010; Springer US; Springer; Springer Nature B.V
• Subjects: Adult; Biochemistry; Biological and medical sciences; Care and treatment; Eosinophilia - complications; Eosinophilia - diagnosis; Esophagitis; Esophagitis - complications; Esophagitis - diagnosis; Esophagoscopy; Esophagus; Esophagus - pathology; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastroenterology; Gastroenterology. Liver. Pancreas. Abdomen; Gastroesophageal reflux; Gastroesophageal Reflux - etiology; Hepatology; Humans; Hypersensitivity, Immediate - complications; Male; Medical research; Medical sciences; Medicine; Medicine & Public Health; Medicine, Experimental; Oncology; Original Article; Other diseases. Semiology; Transplant Surgery; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Refractory reflux disease; Eosinophilic esophagitis; Dysphagia; Human; Gastroesophageal reflux; Refractory; Esophageal disease; Gastroenterology; Esophagitis; ENT disease; Digestive diseases; Metabolic diseases
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-008-0706-z

Background Eosinophilic esophagitis is among the causes of refractory reflux disease. Biopsy of esophagus is the gold standard for diagnosis. In this study we determined the frequency of eosinophilic esophagitis (EE) in refractory reflux cases referred to Motility Department of Shahid Beheshti Research Center of Gastroenterology and Liver Disease, Tehran, Iran. Methods In this cross-sectional study, 68 cases with refractory reflux disease underwent endoscopy and had biopsies taken. Specimens were stained by hematoxylin and eosin and two independent pathologists confirmed the diagnosis of eosinophilic esophagitis. Results Mean (standard deviation, SD) age at diagnosis was 41.8 (10.94) years. All had allergy or atopy, and unknown dysphagia was noted for 66%. Endoscopic findings were as follows: esophagitis (33.3%), rings (33.3%), and whitish plaques (33.3%). Prevalence of eosinophilic esophagitis was 8.8% (N = 6; one man and five women). No statistical difference in demographic variables was found between eosinophilic esophagitis cases and others, except for history of atopy, food impaction, and endoscopic features (P value <0.005). Conclusion Eosinophilic esophagitis should be considered in the differential diagnosis of any cases with refractory reflux who complain of chronic unexplained dysphagia, with history of recurrent food impaction, and atopy or abnormal endoscopic features.