Analysis of symptoms and endoscopic findings in 117 patients with histological diagnoses of eosinophilic esophagitis

 

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Background and study aims: Although eosinophilic esophagitis has been increasingly diagnosed over recent years, little is known about this disease. In this study, symptoms, accompanying allergic disorders, and endoscopic findings in 117 patients with eosinophilic esophagitis were analyzed retrospectively.

Patients and methods: The physicians who had treated the 117 patients (mean age 42.2 years; 9 children, 108 adults; male patients 71.8 %) with the histological diagnosis of eosinophilic esophagitis were asked to provide data on symptoms, accompanying allergic disorders, and endoscopic findings.

Results: In 82.2 % of the patients symptoms appeared in adulthood, predominantly between the ages of 21 and 30 years. The average duration of symptoms until final diagnosis of eosinophilic esophagitis was 4.2 years (range 0 - 44 years). The most frequent symptom was dysphagia (70.1 %), followed by heartburn (47 %), chest pain (29 %), epigastric pain (29 %), and a combination of dysphagia and heartburn (29 %). Allergic disorders were seen in 48.7 % of our patients. The most frequent endoscopic findings were stipple-like exudates (25.6 %), linear fissures (25.6 %), and reddening (25.6 %), followed by rings (18.8 %) and strictures (16.2 %) of the esophagus. The esophageal mucosa was regarded as “normal” in 24.8 % of the patients.

Conclusion: Dysphagia in the second or third decade of life may suggest eosinophilic esophagitis. Symptoms of eosinophilic esophagitis may be indistinguishable from those of gastroesophageal reflux disease. The endoscopic appearance is not specific. Biopsies taken from multiple locations in the esophageal mucosa are essential for diagnosis of eosinophilic esophagitis.

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M. Stolte, MD

Institute of Pathology

Klinikum Bayreuth GmbH

Preuschwitzer Str. 101

95445 Bayreuth, Germany

Fax: +49-921-4005609

Email: mueller.susanna@t-online.de