HOME
Return to Table of Contents
163 EOSINOPHILIC OESOPHAGITIS - AN INCREASINGLY RECOGNIZED CAUSE OF ESOPHAGEAL DISORDERS IN THE YOUNG R Saravanan, SC Grover, G May, G Kandel, PP Kortan, NE Marcon BACKGROUND: Eosinophilic esophagitis is an increasingly recognized condition in young adults. We review our experience in the diagnosis, management and outcome of patients with eosinophilic esophagitis.
Division of Gastroenterology, St Michael's Hospital, Toronto, Ontario
METHODS: Patient demographics were obtained from a retrospective review of charts. Patients with either a clinical or histological diagnosis of eosinophilic esophagitis were included.
RESULTS: 6 patients were diagnosed with eosinophilic esophagitis based on clinical and histological criteria (4 males and 2 females). The average age at diagnosis was 30.6 y (23 to 41 y). 4 patients had a history of asthma (67%). The most common presenting symptom was intermittent dysphagia for an average of 6.7 y (1 to 20 y). Prior to referral, three patients had endoscopy and 4 patients had barium studies. 3 patients were suspected to have Schatzki rings. The most common endoscopic features noted were a multi-ringed esophagus (5/6), linear furrowing (4/6), circumferential oesophagitis (1) and small calibre lumen (1). Histology in five patients confirmed presence of eosinophils in the esophageal tissue. One patient had peripheral eosinophilia and a history of atopy, eczema and asthma. Three patients required esophageal dilations and one patient developed post-procedural pain requiring short-term parenteral nutrition and opiate analgesia. No perforations were noted. One patient did not respond to oral fluticasone or leukotriene inhibitors and two patients have started on oral fluticasone recently and are awaiting clinic followup.
CONCLUSION: Eosinophilic esophagitis is now an increasingly recognized cause for esophageal symptoms including those attributed to oesophageal dysmotility, esophagitis, and other causes of dysphagia. It can be associated with significant morbidity. An awareness and recognition of changes in the mucosal surface of the esophagus on endoscopy may provide the first clue to the diagnosis and may delay or prevent complications such as stricture formation. Long term studies are required to understand the natural history of the condition.