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Esophageal dysmotility is associated with disease severity in eosinophilic esophagitis

Clinical Gastroenterology and Hepatology Nov 12, 2021

Carlson DA, Shehata C, Gonsalves N, et al. - This eosinophilic esophagitis (EoE) cohort frequently exhibited normal secondary peristalsis but an association of abnormal esophageal contractile responses (CRs) with EoE disease severity, especially features of fibrostenosis, was identified. In EoE, esophageal dysmotility was observed in relation to esophageal wall remodeling rather than eosinophilic inflammatory intensity.

  • A cross-sectional study including 199 consecutive adult patients with EoE (ages 18-78, 32% female) that completed 16-cm functional luminal imaging probe (FLIP) during endoscopy.

  • Following FLIP CR patterns were observed: 68 (34%) normal CR, 65 (33%) borderline CR, 44 (22%) impaired/disordered CR, 16 (8%) absent CR, and 6 (3%) spastic-reactive CR.

  • Relative to normal CRs, decreased esophageal distensibility was more frequent in abnormal CRs (distensibility plateau < 17mm in 56% vs 32%).

  • In addition, abnormal CRs more often had greater total EREFS scores (median (interquartile range, IQR) 5 (3-6) vs 4 (3-5) with more severe ring scores, as well as a greater span of symptoms (10 (4-23) vs 7 (3-15) years).

  • Similar mucosal eosinophil density was observed between abnormal CRs and normal CRs: 34 (14-60) vs 25 (5-50) eosinophils/hpf.

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