MedWire News: Patients experiencing swallowing difficulties (dysphagia) should undergo tissue sample tests to see if they have a condition called eosinophilic oesophagitis, US researchers recommend.
Eosinophilic oesophagitis is an allergic inflammatory condition in which the immune system mistakenly attacks cells that line the oesophagus, causing it to narrow until swallowing food becomes difficult. There is some evidence to suggest that the condition may be caused by allergies to certain foods.
Dr Kathryn Peterson, from the University of Utah in Salt Lake City, USA, and team explain that “eosinophilic oesophagitis may be a common finding in adults presenting with dysphagia”, but they add that there is a lack of data to confirm this.
To investigate further, the team studied 261 patients with swallowing difficulties who were referred for oesophageal tests between 2005 and 2007.
All the participants completed questionnaires and underwent an examination in which doctors use an endoscope to look for any abnormalities in the oesophagus. The patients also had oesophageal tissue samples (biopsies) taken for analysis.
Results of these tests revealed that 31 participants met criteria for a diagnosis of eosinophilic oesophagitis.
Patients with eosinophilic oesophagitis were aged an average of 42 years, compared with 61 years for those without the condition.
Eosinophilic oesophagitis affected 22% of patients with asthma, compared with 9% of those without the respiratory condition, and 37% of patients with reported food allergies, compared with just 9% of those without such allergies.
Furthermore, the researchers note that 42% of patients with eosinophilic oesophagitis showed no significant signs of the condition during endoscopic examination. Therefore, the condition would have been missed in these patients if they had not undergone biopsies.
“Eosinophilic oesophagitis was diagnosed in 12% of the patients presenting with dysphagia,” Dr Peterson and team summarise in the journal Alimentary Pharmacology and Therapeutics.
They conclude: “Oesophageal biopsies are warranted in patients presenting with dysphagia, especially in the younger population. Patients may not present with classic endoscopic findings and eosinophilic oesophagitis can be missed without biopsies.”