Eosinophilic esophagitis may be increasing but the prevalence in the general population remains unknown.
Dr Jukka Ronkainen and colleagues from Finland assessed the prevalence and presence of eosinophils in the distal esophageal epithelium in the community.
The team performed esophagogastroduodenoscopy in a random sample of 1000 adults.
Esophageal biopsy samples were obtained from 2 cm above, and at the Z-line.
The researchers defined any eosinophil infiltration of the epithelium as ‘eosinophils present‘.
Definite eosinophilic esophagitis was defined as 20 eosinophils, and probable as 15 to 19 eosinophils.
The team defined possible eosinophilic esophagitis as 5 to 14 eosinophils/high-power field in esophageal biopsy specimens.
|1% had definite or probable eosinophilic esophagitis|
The researchers found eosinophils present in 5% of subjects, and in 54% without troublesome reflux symptoms.
The team found definite eosinophilic esophagitis was present in less than 1% of subjects.
Probable eosinophilic esophagitis occurred in 1% of subjects.
The team observed that erosive esophagitis, and absence of dyspepsia were independent predictors for ‘eosinophils present‘.
Helicobacter pylori infection was also an independent predictor for eosinophils present in subjects.
The researchers noted that definite eosinophilic esophagitis was associated with dysphasia.
Probable eosinophilic esophagitis was associated with narrowing of the esophageal lumen.
Dr Ronkainen's team concluded, “Esophageal eosinophils were present in nearly 5% of the general population.”
“Approximately 1% had definite or probable eosinophilic esophagitis.”
“Esophageal eosinophils may be a manifestation of reflux disease in adults, but the condition is as likely to be asymptomatic and go unrecognized.”