Original article—alimentary tractClinical, Endoscopic, and Histologic Findings Distinguish Eosinophilic Esophagitis From Gastroesophageal Reflux Disease
Section snippets
Study Design and Patients
We conducted a retrospective case-control study at the University of North Carolina (UNC) Hospitals. All patients were selected from the UNC EoE clinicopathologic database, which contains information on patients with esophageal eosinophilia from any cause from January 2000 through December 2007. This resource was originally constructed by searching the UNC pathology database for every esophageal biopsy obtained during this time frame and then narrowing the search to those reports with any
Study Subjects
Of the 456 candidate patients identified in the database for this study, 151 were found to have EoE meeting our case definition, and 226 had GERD meeting our control definition. Of the EoE patients, 79 (52%) had persistent eosinophilia on esophageal biopsy while on acid suppression (69 with a proton pump inhibitor [PPI] and an additional 10 with an H2-receptor antagonist); the remainder did not have a symptom response to acid suppression. There were 22 patients who had either EoE or GERD, but
Discussion
Because the clinical features and histologic findings of EoE are nonspecific and can overlap with GERD and because distinguishing these 2 entities is critical for appropriate patient care, we performed a case-control study comparing patients with EoE with those with GERD. The goal was to determine factors that could reliably differentiate the 2 groups of patients. We found that individual clinical factors (such as age and gender, symptoms of dysphagia and food impaction, the presence of atopic
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This article has an accompanying continuing medical education activity on page 1261. Learning Objectives—At the end of this activity, the learner should be able to differentiate eosinophilic esophagitis from gastroesophageal reflux disease based on clinical, endoscopic, and histological clues.
View this article's video abstract at www.cghjournal.org.
Conflicts of interest The authors disclose no conflicts.
Funding This work is funded in part by a Junior Faculty Development Award from the American College of Gastroenterology and NIH award number KL2RR025746 from the National Center for Research Resources.