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Digestive Diseases and Sciences

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Open Access 13-01-2024 | Eosinophilic Esophagitis | Original Article

A Comprehensive Global Population-Based Analysis on the Coexistence of Eosinophilic Esophagitis and Inflammatory Bowel Disease

Authors: Alexander Malik, Benjamin Douglas Liu, Liangru Zhu, David Kaelber, Gengqing Song

Published in: Digestive Diseases and Sciences | Issue 3/2024

Abstract

Background

We explored inflammatory bowel disease (IBD) and eosinophilic esophagitis (EoE) coexistence using a global dataset. Investigating their epidemiology, risks, and impact, we aimed to enhance the understanding of concurrent diagnoses and patient outcomes.

Methods

A retrospective population-based cohort study was conducted using deidentified patient data from the TriNetX database (2011–2022). We estimated the incidence and prevalence of EoE in patients with IBD, including both Crohn’s disease (CD) and ulcerative colitis (UC), and vice versa. Risks of select immune-mediated conditions and disease complications were compared among patients with EoE, IBD, or concurrent diagnoses.

Results

Our results included 174,755 patients with CD; 150,774 patients with UC; and 44,714 patients with EoE. The risk of EoE was significantly higher among patients with CD (prevalence ratio [PR] 11.2) or UC (PR 8.7) compared with individuals without IBD. The risk of IBD was higher in patients with EoE (CD: PR 11.6; UC: PR 9.1) versus those without EoE. A propensity-matched analysis of IBD patients revealed that, when comparing patients with and without EoE, the relative risk of immune-mediated comorbidities was significantly greater for celiac disease, IBD-related inflammatory conditions, eczema and asthma (CD: n = 1896; UC: n = 1231; p < 0.001). Patients with a concurrent diagnosis of EoE and IBD had a higher composite risk of IBD-related complications (CD: adjusted HR (aHR) 1.14, p < 0.005; UC: aHR 1.17, p < 0.01) and lower risk of food bolus impaction (aHR 0.445, p = 0.0011).

Conclusion

Simultaneous EoE and IBD increased IBD-related complications risk, needing more treatment (glucocorticoids, biologic therapy, abdominal surgery), while reducing EoE-related issues like food bolus impaction.

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Title: A Comprehensive Global Population-Based Analysis on the Coexistence of Eosinophilic Esophagitis and Inflammatory Bowel Disease
Authors: Alexander Malik
Benjamin Douglas Liu
Liangru Zhu
David Kaelber
Gengqing Song
Publication date: 13-01-2024
Publisher: Springer US
Keywords: Eosinophilic Esophagitis
Chronic Inflammatory Bowel Disease
Crohn's Disease
Ulcerative Colitis
Glucocorticoid
Published in: Digestive Diseases and Sciences / Issue 3/2024
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI: https://doi.org/10.1007/s10620-024-08283-2

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Abstract

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