Vanderbilt University Medical Center Nashville, TN, United States
Girish Hiremath, MD, MPH1, Jade Willey, BS2, Aaron Yazdian, MD3, Yash Choksi, MD1 1Vanderbilt University Medical Center, Nashville, TN; 2East Tennessee State University, Johnson City, TN; 3Temple University School of Medicine, Philadelphia, PA
Introduction: Eosinophilic esophagitis (EoE) is a progressive disease complicated by fibrostenosis and esophageal narrowing. Esophageal dilation (ED) is the treatment of choice for fibrostenotic EoE. The aims of this study were to describe the rate of ED and identify the patient factors associated with repeat (≥ 2) ED’s in EoE.
Methods: We reviewed medical records of 755 individuals diagnosed with EoE and seeking care at our institution from 2000 to 2017. EoE was defined per the 2011 guidelines. Demographic (race, gender), clinical (duration of symptoms before being diagnosed with EoE, age at EoE diagnosis, and history of food allergies, asthma, smoking and alcohol consumption), and endoscopic data (number of dilations) was collected. Logistic regression was used for analysis.
Results: In all, 99 (13%) EoE patients underwent ED with a median (min-max) of 1 (1-20) occurrence(s). Individuals who underwent ED (n=99) had significantly longer duration of symptoms prior to their EoE diagnosis, were older at the time of EoE diagnosis, and had a history of smoking exposure and alcohol consumption when compared to those with no history of ED (n=656). A longer duration of symptoms prior to the diagnosis of EoE [odds ratio (OR): 1.01; 95% CI: 1.01-1.03; P=0.03], being diagnosed at an older age [OR: 1.04; 95% CI: 1.02-1.06; P< 0.001], and being White (OR: 1.32 (1.05-1.67) P=0.01)] independently predicted ED. EoE patients who underwent ED ≥ 2 times (n=32) had a longer duration of symptoms prior their EoE diagnosis compared to individuals with only 1 ED (n=67) (128 ± 106 months vs. 59 ± 80 months; P < 0.001). This relationship was statistically significant [OR: 1.01 (1.01-1.02); P=0.009] after adjusting for confounders.
Discussion: Our single-center study involving a large cohort of EoE patients endorses that longer duration of EoE, both in terms of duration of symptoms prior to diagnosis and the duration of disease, increases the need for ED. Prospective studies may help better understand the association between the duration of symptoms before the diagnosis of EoE and repeated EDs.
Disclosures: Girish Hiremath indicated no relevant financial relationships. Jade Willey indicated no relevant financial relationships. Aaron Yazdian indicated no relevant financial relationships. Yash Choksi indicated no relevant financial relationships.
Girish Hiremath, MD, MPH1, Jade Willey, BS2, Aaron Yazdian, MD3, Yash Choksi, MD1. P2410 - Duration of Symptoms Prior to Diagnosis Is Associated with Repeated Esophageal Dilations in Eosinophilic Esophagitis, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.