Esophageal foreign-body impactions: epidemiology, time trends, and the impact of the increasing prevalence of eosinophilic esophagitis

The epidemiology of esophageal foreign-body impaction (EFBI) is poorly described, and the impact of the increasing prevalence of eosinophilic esophagitis (EoE) on this is unknown

Dietary Elimination Therapy Is an Effective Option for Adults With Eosinophilic Esophagitis

Eosinophilic esophagitis (EoE) is an immune-mediated disorder. Food elimination is an established treatment for children, but data in adults are limited. We aimed to determine the response of adults with EoE to dietary therapy

Epidemiology and management of oesophageal coin impaction in children

The epidemiology of oesophageal coin impaction in children is poorly understood. We aimed to assess characteristics of patients with coin impaction and identify predictors of type of coin impacted and management strategies

A phenotypic analysis shows that eosinophilic esophagitis is a progressive fibrostenotic disease

Phenotypes of eosinophilic esophagitis (EoE) are not well characterized

Dietary Elimination Therapy Is an Effective Option for Adults With Eosinophilic Esophagitis

BACKGROUND & AIMS: Eosinophilic esophagitis (EoE) is an immune-mediated disorder. Food elimination is an established treatment for children, but data in adults are limited. We aimed to determine the response of adults with EoE to dietary therapy. METHODS: This was a retrospective cohort study using the University of North Carolina EoE database from 2006–2012. Subjects were ≥18 years, had EoE by consensus guidelines, and had undergone dietary therapy either with targeted or six-food elimination (SFED). Outcomes were symptomatic, endoscopic, and histologic improvement. Demographic, endoscopic, symptomatic, and laboratory predictors of response to dietary therapy were assessed. RESULTS: Of 31 adults who underwent dietary therapy (mean age 36 years; 48% male; 90% white; mean baseline eosinophil count 78 eos/hpf), 22 had targeted and 9 had SFED. Symptoms improved in 71% (68% in targeted, 78% in SFED) and endoscopic appearance improved in 54% (53% in targeted, 56% in SFED). After dietary therapy, the mean eosinophil count decreased to 43 eos/hpf (p=0.009). Eleven subjects (39%) responded with <15 eos/hpf (32% in targeted and 56% in SFED; p=0.41). No clinical, endoscopic, or histologic factors predicted response to dietary therapy. Of the 11 responders, 9 underwent food reintroduction to identify trigger(s), and 4 (44%) reacted to dairy, 4 (44%) to eggs, 2 (22%) to wheat, 1 (11%) to shellfish, 1 (11%) to legumes, and 1 (11%) to nuts. CONCLUSIONS: Dietary elimination is a successful treatment modality for adults with EoE. Further research should emphasize which factors can predict effective dietary therapy

A phenotypic analysis shows that eosinophilic esophagitis is a progressive fibrostenotic disease

Phenotypes of eosinophilic esophagitis (EoE) are not well characterized