EoE Module 7 References-Nicodème et al Clin Gastroenterol Hepatol 2013 Esophageal distensibility as a measure of disease severity in patients with eosinophilic esophagitis

Nicodème et al Clin Gastroenterol Hepatol 2013 Esophageal distensibility as a measure of disease severity in patients with eosinophilic esophagitis

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This study evaluates esophageal distensibility as a predictor of disease severity in patients with eosinophilic esophagitis (EoE). Utilizing high-resolution impedance planimetry with a functional lumen-imaging probe (FLIP), the study measured the ability of the esophagus to stretch in 70 patients (aged 18–68) with EoE and investigated the correlation of these measurements with clinical outcomes like food impaction risk and need for dilation.<br /><br />Results revealed that patients with reduced esophageal distensibility had a higher risk of food impaction and often required esophageal dilation over an average follow-up of 9.2 months. Specifically, a distensibility plateau (DP) of less than 225 mm² was identified as a critical threshold, below which patients were more prone to clinically significant events, including food impaction. Conversely, the severity of mucosal eosinophilia, which is traditionally used for diagnosing EoE, was not linked to these clinical outcomes, showcasing a weak correlation with changes in esophageal distensibility.<br /><br />The study emphasizes that esophageal distensibility, assessed through the DP, is a better predictor of disease severity and intervention necessity in EoE compared to eosinophil density. This suggests that detecting and monitoring esophageal distensibility could complement existing histological assessments, providing a more comprehensive evaluation of EoE's fibrostenotic disease component. Such an approach might eventually lead to improved management by integrating measures to enhance luminal flexibility along with inflammation reduction. Future clinical trials are recommended to further explore the application of esophageal distensibility measurements as a standard biomarker in EoE management.

Keywords

esophageal distensibility

eosinophilic esophagitis

high-resolution impedance planimetry

functional lumen-imaging probe

food impaction

esophageal dilation

distensibility plateau

mucosal eosinophilia

fibrostenotic disease

biomarker