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Delay in diagnosis of eosinophilic esophagitis increases risk for stricture formation

Delay in diagnosis of eosinophilic esophagitis increases risk for stricture formation in a time-dependent manner, finds December's issue of Gastroenterology.

News image

Development of strictures is a major concern for patients with eosinophilic esophagitis (EoE).

At diagnosis, EoE can present with an inflammatory phenotype, a stricturing phenotype, or a combination of these.

Little is known about progression of stricture formation.

Dr Alain Schoepfer and colleagues from Switzerland evaluated stricture development over time in the absence of treatment and investigated risk factors for stricture formation.

The researchers performed a retrospective study using the Swiss EoE Database, collecting data on 200 patients with symptomatic EoE.

The prevalence of esophageal strictures increased with duration of diagnostic delay, from 17% to 71%
Gastroenterology

Stricture severity was graded based on the degree of difficulty associated with passing of the standard adult endoscope.

The median delay in diagnosis of EoE was 6 years, With increasing duration of delay in diagnosis, the prevalence of fibrotic features of EoE, based on endoscopy, increased from 47% to 88%.

Similarly, the team noted that the prevalence of esophageal strictures increased with duration of diagnostic delay, from 17% to 71%.

The research team found that diagnostic delay was the only risk factor for strictures at the time of EoE diagnosis.

Dr Schoepfer's team commented, "The prevalence of esophageal strictures correlates with the duration of untreated disease."

"These findings indicate the need to minimize delay in diagnosis of EoE."

Gastroenterol 2013: 145(6): 1230-1236.e2
28 November 2013

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