Eosinophilic esophagitis is of increasing prevalence and believed to result from allergic processes.
Helicobacter pylori has been inversely associated with allergic diseases, but there is no known relationship between H pylori, eosinophilic esophagitis, and esophageal eosinophilia.
Dr Evan Dellon and colleagues from North Carolina, USA investigated the association between esophageal eosinophilia and H pylori infection.
|Subjects reported symptom episodes 34% of the time|
The research team performed a cross-sectional study of data, collected from a US pathology database, on 165,017 patients in the United States who underwent esophageal and gastric biopsies from 2008 through 2010.
Patients with and without H pylori on gastric biopsy were compared, and odds of esophageal eosinophilia were determined.
From the data analyzed, the team found that 34% had normal esophageal biopsy specimens, 4% had esophageal eosinophilia, and 7% had H pylori infection.
Esophageal eosinophilia was inversely associated with H pylori.
Compared with patients with normal esophageal biopsy specimens, odds of H pylori were reduced among patients with 15 or more eosinophils per high-power field (eos/hpf), 45 or more eos/hpf, 75 or more eos/hpf, and 90 or more eos/hpf.
The researchers observed a similar dose-response trend for increasing clinical suspicion for eosinophilic esophagitis and decreasing prevalence of H pylori.
In addition, severity of histologic effects of H pylori was inversely associated with esophageal eosinophilia.
All trends held in multivariate analysis.
Dr Dellon's team commented, "In a large cross-sectional analysis, H pylori infection was inversely associated with esophageal eosinophilia."
"This relationship could have implications for the pathogenesis and epidemiology of eosinophilic esophagitis."