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Prevalence of eosinophilic esophagitis in patients with gastroesophageal reflux symptoms: A cross-sectional study from a tertiary care hospital in North India

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Abstract

Background

Eosinophilic esophagitis (EoE) is being recognized increasingly all over the globe; Indian data is however sparse. We screened patients with symptoms of gastroesophageal reflux disease (GERD) for presence of EoE in them.

Methods

Consecutive patients with symptoms suggestive of GERD underwent gastroduodenoscopy and esophageal biopsies, obtained from both the upper esophagus (5 cm below the upper esophageal sphincter) and lower esophagus (5 cm above gastroesophageal junction), as well as from any other endoscopically visible abnormal mucosa. Demographic and clinical characteristics, endoscopic findings, peripheral blood eosinophilic count, and history of use of proton-pump inhibitors (PPIs) were analyzed. Stool examination was done to rule out parasitoids. EoE was diagnosed if number of mucosal eosinophil infiltrate was >20 per high-power field. In the latter, Warthin-Starry stain was performed to rule out presence of H elicobacter pylori.

Results

Of 190 consecutive patients with symptoms of GERD screened, esophageal biopsies were available in 185 cases. Of them, 6 had EoE, suggesting a prevalence of 3.2% among patients with GERD. On univariate analysis, history of allergy, non-response to PPI, and absolute eosinophil counts and on multivariable analysis, history of allergy and no response to PPIs were significant predictors of EoE. Presence of EOE did not correlate with severity of reflux symptoms.

Conclusion

In this hospital-based study from northern part of India, prevalence of EoE in patients with GERD was 3.2%. EoE should be considered as a diagnostic possibility, especially in those with history of allergy, no-response to PPI, and absolute eosinophil count of ≥250/cumm.

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Authors and Affiliations

  1. Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India

    Bhaskarjyoti Baruah, Vineet Ahuja & Govind K. Makharia

  2. Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India

    Tarun Kumar, Prasenjit Das & Siddhartha Datta Gupta

  3. Department of Biostatistics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India

    Bhaskar Thakur & Vishnubatla Sreenivas

Authors
  1. Bhaskarjyoti Baruah
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  2. Tarun Kumar
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  3. Prasenjit Das
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  4. Bhaskar Thakur
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  5. Vishnubatla Sreenivas
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  6. Vineet Ahuja
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  7. Siddhartha Datta Gupta
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  8. Govind K. Makharia
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Corresponding author

Correspondence to Govind K. Makharia.

Ethics declarations

The study was approved by the institutional ethics committee.

Conflict of Interest

BB, TK, PD, BT, VS, VA, SDG, and GKM declare that they have no conflicts of interest.

Ethics statement

The study was performed in a manner to conform with the Helsinki Declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com.

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Baruah, B., Kumar, T., Das, P. et al. Prevalence of eosinophilic esophagitis in patients with gastroesophageal reflux symptoms: A cross-sectional study from a tertiary care hospital in North India. Indian J Gastroenterol 36, 353–360 (2017). https://doi.org/10.1007/s12664-017-0789-6

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  • DOI: https://doi.org/10.1007/s12664-017-0789-6

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