The Risk of Esophageal Food Impaction in Eosinophilic Esophagitis Patients: The Role of Clinical and Socioeconomic Factors

• Published in: Clinical and Experimental Gastroenterology
• Main Authors: Alhmoud,Tarik, Ghazaleh,Sami, Ghanim,Marcel, Redfern,Roberta E
• Format: Article in Journal/Newspaper
• Language: English
• Published: Dove Press 2022
• Subjects: Clinical and Experimental Gastroenterology; Toledo; Monroe; Gerd; sami
• Online Access: https://www.dovepress.com/the-risk-of-esophageal-food-impaction-in-eosinophilic-esophagitis-pati-peer-reviewed-fulltext-article-CEG

Tarik Alhmoud,1 Sami Ghazaleh,2 Marcel Ghanim,2 Roberta E Redfern3 1Gastroenterology and Hepatology Division, Toledo Hospital, Toledo, OH, USA; 2Department of Internal Medicine, University of Toledo Medical Center, Toledo, OH, USA; 3Clinical Research Department, Toledo Hospital, Toledo, OH, USACorrespondence: Tarik Alhmoud, Gastroenterology and Hepatology Division, Toledo Hospital, ProMedica Digestive Health Care, 5700 Monroe St, Suite 103 Sylvania, Toledo, Ohio, 43560, USA, Tel [phone], Fax [phone], Email [e-mail]; [e-mail]: Eosinophilic esophagitis (EoE) patients present with dysphagia and often suffer from esophageal food impaction (EFI). EFI can lead to life-threatening perforation, and requires emergent endoscopic intervention. The aim of this study is to evaluate the risk factors for EFI in EoE patients.Methods: This is a retrospective study performed at a tertiary health-care system. Medical records and endoscopy images of EoE cases were reviewed. Clinical characteristics and outcomes including EFIs were documented. We used Zip-code median household income as a surrogate for patients’ socioeconomic status.Results: A total of 291 EoE cases were included, mean age was 42 years. Most patients (65%) had classic EoE endoscopic findings including linear furrows and/or concentric rings; however, a significant proportion (47%) had findings suggestive of gastroesophageal reflux disease (GERD), such as the presence of erosive-esophagitis, a hiatal hernia or Schatzki’s ring. Forty-eight patients (16%) developed one or more esophageal food impaction (EFI). The risk of EFI was less likely in the absence of furrows and/or rings; odds ratio (OR) = 0.28, 95% CI (0.11, 0.72) [P = 0.008]. Females had less EFI risk; OR = 0.42, 95% CI (0.19, 0.95) [P = 0.04]. The type of medical insurance and socioeconomic status was not associated with EFI risk.Conclusion: EFI risk is higher in EoE patients with esophageal furrows and/or rings and in men. Aggressive ...