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Eosinophilic esophagitis in children

The latest issue of the Journal of Gastroenterology reports on the epidemiology of eosinophilic esophagitis in children and adolescents.

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Eosinophilic esophagitis is defined by infiltration of eosinophils in the esophageal mucosa.

The epidemiology and seasonal variation have not been well studied in children and adolescents.

Dr Serge Alexander Sorser and colleagues examined esophageal biopsies performed from 2001 to 2006 on patients younger than 21 year of age, focusing on demographics, onset and duration of presenting symptoms, history of allergies, and endoscopic findings.

A total of 753 upper endoscopies were performed, 44 of which showed histologic evidence of eosinophilic esophagitis.

The research team noted that 50% of all eosinophilic esophagitis endoscopies were grossly normal.

Onset of symptoms was 23% in the spring, 29% in the summer, 23% in the fall, and 25% in the winter.

More cases were diagnosed in the fall.

Onset of symptoms was 23% in the spring
Journal of Gastroenterology

The doctors reported that time between onset of symptoms and diagnosis was 115 days.

The researchers found that the most common presenting symptoms were vomiting, dysphagia, abdominal pain, feeding disorders, heartburn, food impaction, vague chest pain and diarrhea.

The research team observed that children presenting with vomiting and feeding disorders were younger, whereas children presenting with heartburn and dysphagia were older.

The incidence of eosinophilic esophagitis did not increase between 2001 and 2006.

Dr Sorser's team concludes, "Onset of symptoms did not vary by season, indicating that allergens triggering eosinophilic esophagitis are present all year around."

"Vomiting and feeding disorders are seen in young children, while dysphagia and heartburn are seen in older children."

"As endoscopic findings were normal in 50 % of cases, an esophageal biopsy should be performed in all patients with suspected eosinophilic esophagitis." 

J Gastroenterol 2013 :48(1): 81-85
23 January 2013

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