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Incidence and features of eosinophilic esophagitis in dysphagia: a prospective observational study

Abstract Objective: The incidence and symptoms associated with eosinophilic esophagitis (EoE) varies with geographic location, present in 7–15% dysphagic European or North American adults. We aimed to determine incidence and features of EoE in a dysphagic New Zealand population. Materials and methods: 101 consecutive patients presenting with dysphagia to a New Zealand teaching hospital completed a questionnaire (demographics and history) before upper gastrointestinal endoscopy and esophageal biopsies. Results: The incidence of EoE was 14.1% in those having esophageal biopsies. Patients with EoE were younger (median age 38 years, cohort 58 years: OR 9.2 for age ≤40; p < 0.001), more frequently male (19.1% versus 7.4% of females: OR 4.7; p < 0.05), and had longer symptom duration (median 262 weeks versus 130.6 weeks: p = NS) with non-continuous symptoms (continuous symptoms 8.3% EoE versus 16.2% cohort: p = NS). Progressive symptoms, level of dysphagia and history of allergy/atopy occurred with almost identical frequency in those with and without EoE. Classic endoscopic features of EoE had a sensitivity and specificity of 30.6 and 93.2%, respectively. Conclusions: EoE occurs in an adult dysphagic population in New Zealand with similar frequency to that reported in Europe and North America. Demographics and features of history associated with EoE are described and the need to take esophageal biopsies in this population emphasized by the relatively low sensitivity of endoscopic features for the condition.