It is still considered underreported, even though it becoming more common, possibly because of dietary changes and environmental factors, the panelists said.
Explore This IssueAugust 2009
In the survey of ABEA members, nearly 79% of the respondents said they work in academic settings, 15% in private institutions, and just over 6% in multispecialty operations, according to results presented by Douglas Johnston, MD, of the Department of Otolaryngology-Head and Neck Surgery at Thomas Jefferson University Hospital in Philadelphia. Just under 59% treat adults, nearly 24% treat children, and almost 18% treat both.
Fifty of the 80 ABEA members who responded (62.5%) said they specialize in swallowing disorders, but 15 of them (18.8%) reported that they were not aware of the disorder. Pediatric otolaryngologists had significantly greater awareness, however.
Still, 61.5% of the respondents said that they have treated eosinophilic esophagitis and almost 30% of them said they have treated more than five patients for it.
Diagnoses of eosinophilic esophagitis were made by gastroenterologists in 62.5% of the cases, the respondents reported. The main factor leading to the diagnosis was laryngopharyngeal reflux refractory to acid suppression, which was an indicator just under 70% of the time. Trouble with swallowing solid foods was a factor 60% of the time, food impaction about 50% of the time, endoscopic signs of LPR refractory to acid suppression just over 30%, and a barium swallow with a ringed esophagus about 18% of the time, according to the survey results.
Signs of the disease seen during an endoscopic exam are linear streaking, mucosal plaques or nodularity, a ringed esophagus, an appearance similar to crepe paper, and stricture.
Four of the survey respondents reported esophagoscopy complications, including linear tears and perforation.
When otolaryngologists diagnose eosinophilic esophagitis, what do they do?
Of the 43 respondents who answered the question, 32 (just under 75 %) made a referral to a gastroenterologist, just over 72% had the patient swallow topical corticosteroids, around 51% used acid suppression and about 37% tried an elimination diet.
Symptoms and Diagnosis
Dr. Alexander said eosinophilic esophagitis is now about as prevalent as Crohn’s disease. Estimates on how many people have the disease range from seven to 120 per 100,000, he said.
According to a 2006 study involving 325 patients (Eur J Gastroenterol Hepatol 2006;18:211), the average age of adults suffering from the disease is 35 to 45, with 52% of them having allergies and 31% with eosinophilia.