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Subjective Symptoms in Patients with Eosinophilic Esophagitis Are Related to Esophageal Wall Thickness and Esophageal Body Pressure

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Abstract

Background

Endoscopic ultrasonography (EUS) and high-resolution manometry (HRM) can be used in the evaluation of eosinophilic esophagitis (EoE) for frequent symptoms such as dysphagia. However, the role of these examinations is not clear.

Aims

The aim of this study was to objectively evaluate the subjective symptoms of EoE patients with EUS and HRM.

Methods

Patients who had endoscopic findings indicative of EoE and matched the number of eosinophil infiltrates used as diagnostic criteria were recruited between September 2018 and August 2019. Evaluable subjects underwent EUS and HRM and completed the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire. The esophageal wall thickness (evaluated with EUS) and HRM parameters between patients with and without symptoms were retrospectively compared. Symptomatic patients were re-examined using EUS and HRM 6 months after treatment.

Results

A total of 35 patients (29 males, median age of 49 years) were divided into symptomatic (20 patients) and asymptomatic groups (15 patients). The esophageal wall was thicker, and the distal contractile integral (DCI) values were higher in the symptomatic group (P < 0.001). In addition, DCI values were positively correlated with esophageal wall thickness. After treatment, the GSRS scores showed an improving trend for each item. Esophageal wall thickness and DCI values were significantly decreased (Ps < 0.001).

Conclusions

Esophageal wall thickening and increased esophageal body pressure may be involved in subjective symptoms. In addition, treatment may reduce esophageal thickness and pressure along with improvement of subjective symptoms.

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Acknowledgments

We thank Dr. Obayashi Tomohiko for editing a draft of this manuscript.

Funding

None.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Koichi Muroi, Naomi Kakushima, Kazuhiro Furukawa, Eri Ishikawa, Takuya Ishikawa, Takeshi Yamamura, Eizaburo Ohno, Masanao Nakamura & Mitsuhiro Fujishiro

  2. Department of Endoscopy, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Tsunaki Sawada, Keiko Maeda & Hiroki Kawashima

  3. Department of Gastroenterology, Fujita Health University School of Medicine, 1-98, Dengakugakubo, Kutsukake-chou, Toyoake, Aichi, 470-1192, Japan

    Kohei Funasaka & Ryoji Miyahara

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  1. Koichi Muroi
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  2. Naomi Kakushima
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Corresponding author

Correspondence to Kazuhiro Furukawa.

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Authors declare no conflict of interests for this article.

Ethical considerations

This study was conducted after approval from the Ethics Committee of Nagoya University and was performed in accordance with the Helsinki Declaration. An information sheet containing information about the study and an opt-out form for patients wishing to opt-out of the study were posted online.

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Muroi, K., Kakushima, N., Furukawa, K. et al. Subjective Symptoms in Patients with Eosinophilic Esophagitis Are Related to Esophageal Wall Thickness and Esophageal Body Pressure. Dig Dis Sci 66, 2291–2300 (2021). https://doi.org/10.1007/s10620-020-06527-5

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  • DOI: https://doi.org/10.1007/s10620-020-06527-5

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