Eosinophilic esophagitis associated with increased prevalence of IBD

SAN DIEGO — Patients with eosinophilic esophagitis — particularly those with significantly increased level of eosinophils — are almost twice as likely to simultaneously have inflammatory bowel disease, a speaker said here.

“While a section bias for patients who undergo same-day bidirectional endoscopy cannot be excluded, the possibility that EoE [eosinophilic esophagitis] and inflammatory bowel disease [IBD] share some common immunopathogenetic mechanisms is intriguing and deserves further investigation,” the researchers said.

The study examined histopathologic, demographic and clinical information from 48,947 patients (median age, 58 years; 64% men) who had simultaneous esophageal and ileocolonic biopsies between January 2008 and June 2012. Those with a history or diagnosis of gastrointestinal cancer or surgery were excluded.

Remaining patients (n=47,150) were divided into three groups based on numbers of eosinophils per high-power field (eos/HPF) in their esophageal squamous mucosa, after which the relative prevalence of ulcerative colitis and Crohn’s disease was determined for each group.

The study found patients with more than 60 eos/HPF also were more likely to have ulcerative colitis (OR=1.93; 95% CI, 1.38-2.69) than those with fewer than 15 eos/HPF. Crohn’s disease comparisons did not rise to statistical significance.

“If you have patients with IBD that are having upper gastrointestinal symptoms — especially dysphagia, food impaction, difficulty swallowing — it’s important to biopsy the esophagus to rule out eosinophilic esophagitis,” researcher Maria McIntire, MD, of the Miraca Life Sciences Research Institute, said.

Disclosure: McIntire reports no relevant financial disclosures.

For more information:

McIntire M. #8: Eosinophilic Esophagitis Is Associated with an Increased Prevalence of Inflammatory Bowel Disease. Presented at: the 2013 American College of Gastroenterology Annual Scientific Meeting; Oct. 11-16, San Diego.