Retrospective Analysis of Eosinophilic Esophagitis in Patients with Refractory Gastroesophageal Reflux Disease

Anis, Khurram; Chandnani, Aakash; Ahmed, Mumtaz; Shaukat, Faizan

doi:10.7759/cureus.5252

Cited by 7 publications

(8 citation statements)

References 11 publications

(15 reference statements)

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“…All patients had 'feline oesophagus' on endoscopy with micro-abscesses visible in some, with a history of atopy, complaints of dysphagia and food impaction. [15] Comparable to the above mentioned results of previous studies, our studies presented the same results that prevalence of EoE among GERD patients was 9%. Only a few studies have looked at the possibility of GERD and EoE coexisting.…”

Section: Discussionsupporting

confidence: 89%

Prevalence of Eosinophilic Esophagitis in Patients with Gastroesophageal Reflux Symptoms: A Cross-Sectional Study

Amim¹,

Saeed²,

Shah³

et al. 2022

PJMHS

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Objective:Prevalence of eosinophilic esophagitis in patients with gastroesophageal reflux symptoms. Study Design:A Cross-sectional Study Place and Duration:The study was conducted at Gastroenterology department of DHQ Teaching Hospital, Timargarafor six months from August 2021 to January 2022. Methods: There were 300 patients of both genders presented in this study. Individuals who agreed to participate, their personal information such as age, gender, height and weight was recorded with their informed permission. Included patients were had gastroesophageal reflux symptoms. Esophageal biopsies of all the patients were underwentesophagogastroduodenoscopy (EGD). Prevalence of eosinophilic esophagitis was recorded among all cases. SPSS 23.0 was used to analyze all data. Results: The mean age of the patients was 41.9±8.21 years and had mean BMI 25.7±6.31 kg/m2. Majority of the patients were males 190 (63.3%) and 110 (36.7%) were females. We found that frequency of eosinophilic esophagitis among all cases were 27 (9%). Among 27 cases of EoE, males were higher in number 19 (70.4%) than females 8 (29.6%). Among these cases, heartburn was the most common symptom found in 10 (37.03%) cases, followed by dysphagia in 6 (22.2%), epigastric pain in 5 (18.5%). Lower esophagus found in 12 (44.4%) cases and mid in 15 (55.6%) cases. Mean eosinophils was 24.4±7.29 per HPF. As per histological findings,eosinophilicmicroabscess was found in 20 (70.1%) cases. Conclusion:Patients with refractory GERD are at risk of developing eosinophilic esophagitis, which can be life-threatening. Dysphagia, heartburn, and food impaction are all possible symptoms. The EoE screening of elderly patients with prolonged GERD, atopy, and non-response to stomach acid inhibitors must be evaluated. Keywords: Refractory GERD, Eosinophilic Esophagitis, Dysphagia, Heartburn

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Section: Discussionsupporting

confidence: 89%

Prevalence of Eosinophilic Esophagitis in Patients with Gastroesophageal Reflux Symptoms: A Cross-Sectional Study

Amim¹,

Saeed²,

Shah³

et al. 2022

PJMHS

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“…A recent study found that EE can relapse within 2 weeks after stopping PPIs, with some patients even developing LA grade C EE (63). EoE has been seen in 1%-8% of patients with refractory GERD (24,(167)(168)(169)(170). Temporarily discontinuing PPIs before endoscopy in these patients may unmask the EoE histology, which could be obscured if endoscopy is performed on PPIs, missing an opportunity to identify the cause of ongoing GERD symptoms.…”

Section: Endoscopymentioning

confidence: 99%

ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease

et al. 2021

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Gastroesophageal reflux disease (GERD) continues to be among the most common diseases seen by gastroenterologists, surgeons, and primary care physicians. Our understanding of the varied presentations of GERD, enhancements in diagnostic testing, and approach to patient management have evolved. During this time, scrutiny of proton pump inhibitors (PPIs) has increased considerably. Although PPIs remain the medical treatment of choice for GERD, multiple publications have raised questions about adverse events, raising doubts about the safety of long-term use and increasing concern about overprescribing of PPIs. New data regarding the potential for surgical and endoscopic interventions have emerged. In this new document, we provide updated, evidence-based recommendations and practical guidance for the evaluation and management of GERD, including pharmacologic, lifestyle, surgical, and endoscopic management. The Grading of Recommendations, Assessment, Development, and Evaluation system was used to evaluate the evidence and the strength of recommendations. Key concepts and suggestions that as of this writing do not have sufficient evidence to grade are also provided.

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“…Our results were in agreement with others (24) , who observed that the main symptoms experienced by patients were heartburn (80.8%), regurgitation (65.8%), and atypical symptoms (53.4%). However, Anis et al (25) reported that dysphagia was the chief complaint leading to EGD followed by food impaction and heartburn.…”

Section: Discussionmentioning

confidence: 99%

Eosinophilic Esophagitis among Patients with Refractory Gastroesophageal Reflux Disease

Rizk,

Mohamed,

K. ElAlfy

et al. 2024

Benha Medical Journal

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Background: Eosinophilic esophagitis (EoE) may be linked to gastroesophageal reflux disease (GERD) in as many as 30% of patients of EoE. The aim is to study the prevalence and clinical presentation of Eosinophilic esophagitis among patients with refractory GERD. Methods: This cross-sectional study was conducted on 181 patients presented with persistent GERD symptoms despite double dose PPI therapy for at least 8 weeks without interruption, who were referred to gastroenterology unit of Internal Medicine Department at Benha University Hospitals. All patients were subjected to proper and detailed history taking and thorough clinical examination, laboratory investigations including complete blood count with differential leucocytic count and upper gastrointestinal endoscopy and biopsy for histopathological examination. Results: The mean age of the patients was 36.7±11.46 years. One hundred and three (56.9%) patients were males and 78 (43.1%) were females. Among the studied cases, 9 (5.0%) cases had EoE and 2 (1.1%) cases had eosinophilic gastroenteritis. Peripheral eosinophilia was found in 6 (66.7%) of EoE cases. EoE cases had statistically significant higher incidence of atopy, dysphagia, food impaction, furrows, white plaques, concentric rings and strictures compared to refractory GERD patients without EoE (P<0.05). Conclusions: Our results showed that 5% of patients with refractory GERD had EoE. EoE cases had significantly higher association with history of atopy. Most patients with EoE presented with dysphagia and food impaction. Endoscopic features of EoE patients included furrows, white plaques, strictures and concentric rings. EoE cases have higher incidence of having peripheral eosinophilia at their CBCs.

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Retrospective Analysis of Eosinophilic Esophagitis in Patients with Refractory Gastroesophageal Reflux Disease

Cited by 7 publications

References 11 publications

Prevalence of Eosinophilic Esophagitis in Patients with Gastroesophageal Reflux Symptoms: A Cross-Sectional Study

Prevalence of Eosinophilic Esophagitis in Patients with Gastroesophageal Reflux Symptoms: A Cross-Sectional Study

ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease

Eosinophilic Esophagitis among Patients with Refractory Gastroesophageal Reflux Disease

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