Abstract
Background
Eosinophilic esophagitis (EoE) is the most common cause of dysphagia and esophageal food impaction (EFI) in the USA, Western Europe, and Australia. In Mexico, the uncomplicated form of this disease is infrequent, and prevalence in patients with EFI is unknown.
Aims
To determine the prevalence and causes of EFI, endoscopic and therapeutic aspects, and establish the prevalence of biopsy-proven EoE in patients with EFI.
Methods
Diagnostic upper gastrointestinal endoscopy reports from January 2011 to December 2016 were retrospectively reviewed. Patients with therapeutic procedures, gastrointestinal hemorrhage, or non-food foreign body impaction were excluded. The number of patients with EFI was determined. Additionally, patients with esophageal biopsy were retained for EoE prevalence calculation. The diagnosis of EoE was defined with the presence of eosinophil infiltration count ≥ 15/high-power field with or without typical endoscopic abnormalities.
Results
A total of 4700 reports of the same number of patients were selected; 2209 were males (47%) with a mean age of 57.6 ± 12.3 years (range 14–93). We identified 36 patients with EFI (0.76, 95% CI 0.51–1.01), 16 males (44.4%) with a mean age of 54.9 ± 19.7 (range 22–92). Esophageal biopsies were obtained in 17/36 (47.2%) cases. The diagnosis of EoE was confirmed in 2 patients (11.7%). Peptic stenosis was the most frequent cause of EFI.
Conclusions
EoE is an infrequent cause of EFI in the Mexican population (11.7%). EoE had the lowest prevalence compared to that reported in Caucasian populations. The prevalence of EFI was also low.
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References
Dellon ES, Gonsalves N, Hirano I, Furuta GT, Liacouras CA, Katzka DA. The American College of Gastroenterology. ACG clinical guideline: evidenced based approach to the diagnosis and management of esophageal eosinophilia and eosinophilic esophagitis (EoE). Am J Gastroenterol. 2013;108:679–692.
Landres RT, Kuster GG, Strum WB. Eosinophilic esophagitis in a patient with vigorous achalasia. Gastroenterology. 1978;74:1298–1301.
Syed AA, Andrews CN, Shaffer E, Urbanski SJ, Beck P, Storr M. The rising incidence of eosinophilic oesophagitis is associated with increasing biopsy rates: a population-based study. Aliment Pharmacol Ther. 2012;36:950–958.
Kidambi T, Toto E, Ho N, Taft T, Hirano I. Temporal trends in the relative prevalence of dysphagia etiologies from 1999–2009. World J Gastroenterol. 2012;18:4335–4341.
van Rhijn BD, Verheij J, Smout AJ, Bredenoord AJ. Rapidly increasing incidence of eosinophilic esophagitis in a large cohort. Neurogastroenterol Motil. 2013;25:e5.
De la Cruz-Patiño E, Ruíz-Juárez I, Meixueiro-Daza A, Grube-Pagola P, Roesch-Dietlen F, Remes-Troche JM. Eosinophilic esophagitis prevalence in an adult population undergoing upper endoscopy in southeastern México. Dis Esophagus. 2015;28:524–529.
García-Compeán D, González González JA, Marrufo García CA, et al. Prevalence of eosinophilic esophagitis in patients with refractory gastroesophageal reflux disease symptoms: a prospective study. Dig Liver Dis. 2011;43:204–208.
Sa CC, Kishi HS, Silva-Werneck AL, et al. Eosinophilic esophagitis in patients with typical gastroesophageal reflux disease symptoms refractory to proton pump inhibitor. Clinics (Sao Paulo). 2011;66:557–561.
González FC, Torres J, Molina UR, Harris PR. Eosinophilic esophagitis: report of three cases. Rev Med Chil. 2009;137:666–671.
Pavez-Ovalle C, Silva CJ, Díaz FR. Esofagitis eosinofílica. A propósito de un caso clínico. Gastr Latinoam. 2006;17:73–78.
Planzer M. Esofagitis eosinofílica. Gastr Latinoam. 2007;18:136–140.
Schoepfer AM, Safroneeva E, Bussmann C, et al. Delay in diagnosis of eosinophilic esophagitis increases risk for stricture formation in a time-dependent manner. Gastroenterology. 2013;145:1230–1236.
Straumann A. The natural history and complications of eosinophilic esophagitis. Gastrointest Endosc Clin N Am. 2008;18:99–118.
Dellon ES. Epidemiology of eosinophilic esophagitis. Gastroenterol Clin N Am. 2014;43:201–218.
Richter JE. Eosinophilic esophagitis dilation in the community—try it—you will like it—but start low and go slow. Am J Gastroenterol. 2016;111:214–216.
Ukleja A, Shiroky J, Agarwal A, Allende D. Esophageal dilations in eosinophilic esophagitis: a single center experience. World J Gastroenterol. 2014;20:9549–9555.
Molina-Infante J, Gonzalez-Cordero PL, Lucendo AJ. Proton pump inhibitor-responsive esophageal eosinophilia: still a valid diagnosis? Curr Opin Gastroenterol. 2017;33:285–292.
Lucendo AJ, Molina-Infante J, Arias A, et al. Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults. United Eur Gastroenterol J. 2017;5:335–358.
Hirano I, Moy N, Heckman MG, Thomas CS, Gonsalves N, Achem SR. Endoscopic assessment of the oesophageal features of eosinophilic esophagitis: validation of a novel classification and grading system. Gut. 2013;62:489–495.
Straumann A, Bussmann C, Zuber M, Vannini S, Simon HU, Schoepfer A. Eosinophilic esophagitis: analysis of food impaction and perforation in 251 adolescent and adult patients. Clin Gastroenterol Hepatol. 2008;6:598–600.
Desai TK, Stecevic V, Chang CH, Goldstein NS, Badizadegan K, Furuta GT. Association of eosinophilic inflammation with esophageal food impaction in adults. Gastrointest Endosc. 2005;61:795–801.
Kerlin P, Jones D, Remedios M, Campbell C. Prevalence of eosinophilic esophagitis in adults with food bolus obstruction of the esophagus. J Clin Gastroenterol. 2007;41:356–361.
Byrne KR, Panagiotakis PH, Hilden K, Thomas KL, Peterson KA, Fang JC. Retrospective analysis of esophageal food impaction: differences in etiology by age and gender. Dig Dis Sci. 2007;52:717–721.
Sperry SL, Crockett SD, Miller CB, Shaheen NJ, Dellon ES. Esophageal foreign-body impactions: epidemiology, time trends, and the impact of the increasing prevalence of eosinophilic esophagitis. Gastrointest Endosc. 2011;74:985–991.
Hurtado CW, Furuta GT, Kramer RE. Etiology of esophageal food impactions in children. J Pediatr Gastroenterol Nutr. 2011;52:43–46.
Kirchner GI, Zuber-Jerger I, Endlicher E, et al. Causes of bolus impaction in the esophagus. Surg Endosc. 2011;25:3170–3174.
Mahesh VN, Holloway RH, Nguyen NQ. Changing epidemiology of food bolus impaction: Is eosinophilic esophagitis to blame? J Gastroenterol Hepatol. 2013;28:963–966.
Heerasing N, Lee SY, Alexander S, Dowling D. Prevalence of eosinophilic oesophagitis in adults presenting with oesophageal food bolus obstruction. World J Gastrointest Pharmacol Ther. 2015;6:244–247.
Philpott H, Nandurkar S, Thien F, et al. Seasonal recurrence of food bolus obstruction in eosinophilic esophagitis. Intern Med J. 2015;45:939–943.
Hiremath GS, Hameed F, Pacheco A, Olive A, Davis CM, Shulman RJ. Esophageal food impaction and eosinophilic esophagitis: a retrospective study, systematic review, and meta-analysis. Dig Dis Sci. 2015;60:3181–3193.
Gretarsdottir HM, Jonasson JG, Bjornsson ES. Etiology and management of esophageal food impaction: a population based study. Scand J Gastroenterol. 2015;50:513–518.
Truskaite K, Dlugosz A. Prevalence of eosinophilic esophagitis and lymphocytic esophagitis in adults with esophageal food bolus impaction. Gastroenterol Res Pract. 2016;2016:9303858.
Furuta GT, Liacouras CA, Collins MH, et al. First International Gastrointestinal Eosinophil Research Symposium (FIGERS) Subcommittees. Eosinophilic esophagitis in children and adults: a systematic review and consensus recommendations for diagnosis and treatment. Gastroenterology. 2007;133:1342–1363.
Liacouras CA, Furuta GT, Hirano I, et al. Eosinophilic esophagitis: updated consensus recommendations for children and adults. J Allergy Clin Immunol. 2011;128:e6.
García-Compeán D, González-González JA, González-Moreno EI, Maldonado-Garza HJ. Eosinophilic esophagitis. The North against the South? A bio-economic-social mechanistic approach and clinical implications. Rev Gastroenterol Mex. 2017;82:328–336.
O’Shea KM, Aceves SS, Dellon ES, et al. Pathophysiology of eosinophilic esophagitis. Gastroenterology. 2017;. https://doi.org/10.1053/j.gastro.2017.06.065.
Okada H, Kuhn C, Feillet H, Bach JF. The ‘hygiene hypothesis’ for autoimmune and allergic diseases: an update. Clin Exp Immunol. 2010;160:1–9.
Dellon ES, Peery AF, Shaheen NJ, et al. Inverse association of esophageal eosinophilia with Helicobacter pylori based on analysis of a US pathology database. Gastroenterology. 2011;141:1586–1592.
Jensen ET, Dellon ES. Environmental and infectious factors in eosinophilic esophagitis. Best Pract Res Clin Gastroenterol. 2015;29:721–729.
Yu CH, Sterling D, Albayati I, Al-obaidi S, et al. The prevalence of biopsy-proven eosinophilic esophagitis in hispanics undergoing endoscopy is infrequent compared to caucasians: a cross-sectional study. Dig Dis Sci. 2017;62:3511–3516.
Bohm M, Malik Z, Sebastiano C, et al. Mucosal eosinophilia: prevalence and racial/ethnic differences in symptoms and endoscopic findings in adults over 10 years in an urban hospital. J Clin Gastroenterol. 2012;46:567–574.
Moawad FJ, Dellon ES, Achem SR, et al. Effects of race and sex on features of eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2016;14:23–30.
Soto-Solís R, Santana-de Anda K, González-Uribe N, et al. Cómo mejorar el diagnóstico de esofagitis eosinofílica: experiencia de una serie de casos en México. Rev Gastroenterol Mex. 2017;82:5–12.
Vazquez-Elizondo G, Ngamruengphong S, Khrisna M, Devault KR, Talley NJ, Achem SRI. The outcome of patients with esophageal eosinophilic infiltration after an eight-week trial of a proton pump inhibitor. Aliment Pharmacol Ther. 2013;38:1312–1319.
Molina-Infante J, Rivas MD, Hernandez-Alonso M, et al. Proton pump inhibitor-responsive esophageal eosinophilia correlates with downregulation of eotaxin-3 and Th2 cytokines overexpression. Aliment Pharmacol Ther. 2014;40:955–965.
Podboy A, Katzka DA, Enders F, et al. Esophageal narrowing on barium oesophagram is more common in adult patients with eosinophilic esophagitis than PPI-responsive esophageal eosinophilia. Aliment Pharmacol Ther. 2016;43:1168–1177.
García-Compeán D, González-Moreno EI, González-González JA, Borjas-Almaguer OD, Maldonado-Garza HJ. Lack of compliance with consensus recommendations on the diagnosis of eosinophilic esophagitis (EoE) in published prevalence studies. A clinical and systematic review. J Dig Dis. 2016;17:660–669.
Benjamin SB. Esophageal foreign bodies and food impactions. Gastroenterol Hepatol (N Y). 2008;4:546–548.
Ikenberry SO, Jue TL, Anderson MA, et al. Management of ingested foreign bodies and food impactions. Gastrointest Endosc. 2011;73:1085–1091.
Singh B, Nijhawan S, Narayan KS, Kumar A. Endoscopic management of ingested foreign bodies and food impaction in esophagus. J Dig Endosc. 2015;6:96–100.
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García-Compeán, D., González-González, J.A., Duran-Castro, J.J. et al. Low Prevalence of Biopsy-Proven Eosinophilic Esophagitis in Patients with Esophageal Food Impaction in Mexican Population. Dig Dis Sci 63, 1506–1512 (2018). https://doi.org/10.1007/s10620-018-5037-0
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DOI: https://doi.org/10.1007/s10620-018-5037-0