EoE ToT Module 4 References-Ekre et al Dis Esophagus 2020 Retrospective chart review Seasonal variation in incidence of bolus impaction EoE atopy

Ekre et al Dis Esophagus 2020 Retrospective chart review Seasonal variation in incidence of bolus impaction EoE atopy

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This retrospective chart review examined the seasonal variation in the incidence of esophageal bolus impaction, focusing on patients with eosinophilic esophagitis (EoE) and atopic disorders. Conducted at the NÄL Medical Centre Hospital (Sweden) over a 14-year period (2004-2017), the study reviewed 755 cases of esophageal bolus impaction. EoE is a chronic inflammatory condition characterized by eosinophilic infiltration of the esophageal mucosa, leading to symptoms like dysphagia, often resulting in bolus impaction.<br /><br />The study found a statistically significant higher occurrence of soft bolus impaction in summer and fall in patients with confirmed EoE or atopy, but not in nonatopic patients or those with a negative biopsy result. EoE was identified in 48% of biopsied patients. Among 233 atopic cases, a significant seasonal variation in impactions was retained within subgroups, especially among those with allergies confirmed by tests or interviews. However, this seasonal variation wasn’t observed in nonatopic patients or those with negative biopsies.<br /><br />The findings suggest a potential link between seasonal allergens and increased incidence of food bolus impaction in patients with EoE or atopic conditions, even though the study design didn’t allow for establishing a direct causal relationship. The study also underscored that despite an increasing recognition of EoE, the overall incidence of food bolus impaction remained constant over 14 years, indicating a possible gap in diagnosis or treatment adherence for EoE. The authors discussed the need for better management strategies for EoE and the importance of systematic biopsy in cases of food bolus impaction to prevent misdiagnosis.<br /><br />The study’s limitations included its retrospective nature, incomplete medical records, and inconsistent biopsy rates. Despite these, it provided significant insights into the seasonal patterns of bolus impaction linked to EoE and atopic conditions, suggesting potential avenues for improving patient care through targeted interventions during high-risk periods.

Keywords

esophageal bolus impaction

eosinophilic esophagitis

seasonal variation

atopic disorders

NÄL Medical Centre Hospital

food bolus impaction

allergens

dysphagia

biopsy

patient care