Number of bottles of esophageal biopsies in the evaluation of eosinophilic esophagitis and clinical outcomes - 11/08/23
, John Middleton a , Paul M. Travers b , Hassan Ghoz c, Dawn Francis a , Kenneth R. DeVault a , Maoyin Pang a, ⁎ Highlights |
• | Eosinophilic esophagitis is diagnosed through esophageal biopsies. |
• | The optimal number and location of bottles for esophageal biopsies is unclear. |
• | An increased number of bottles for esophageal biopsies can raise costs. |
• | Patient outcomes did not differ between patients with one and two bottles. |
• | One bottle of biopsies may be non-inferior to two in eosinophilic esophagitis. |
Abstract |
Background |
The number of bottles of esophageal biopsies needed for the evaluation of eosinophilic esophagitis (EoE) is unclear, despite cost differences.
Aims |
Assess the clinical outcomes between patients with one and two bottles of esophageal biopsies for the assessment of EoE.
Methods |
Retrospective study of adults who underwent esophagogastroduodenoscopy (EGD) for esophageal symptoms between January 2015 and June 2021 and findings of ≥15 eosinophils per high power field (eos/hpf). Patients with one bottle (1 bottle-EoE) had biopsies from the entire or proximal esophagus. Patients with two bottles had biopsies separated from the distal and proximal esophagus and were separated into those with ≥ 15 eos/hpf in both bottles (2 bottle Dif-EoE), or the distal bottle alone (2 bottle Lim-EoE). The primary outcomes were endoscopic findings at follow-up EGD as assessed by the Eosinophilic Esophagitis Endoscopic Reference Score (EREFS) and the presence of ≥15 eos/hpf.
Results |
Of 85 patients with esophageal eosinophilia who met inclusion criteria, 49 had 2 bottle Dif-EoE, 18 had 2 bottle Lim-EoE, and 18 had 1 bottle-EoE. At median follow-up of 3.3–5.6 months, more patients with 1 bottle EoE had dysphagia (p = 0.029), however there were no differences in the EREFS (p = 0.14) or presence of ≥15 eos/hpf (p = 0.39). More patients with 2 bottle Dif-EoE were treated with topical steroids (16.3% vs. 0% vs. 0%, p = 0.039) and diet (20.4% vs. 0% vs. 5.6%, p = 0.05).
Conclusion |
Endoscopic and histologic outcomes were similar in patients who had one and two bottles for esophageal biopsies in the evaluation of EoE.
Le texte complet de cet article est disponible en PDF.Keywords : Dysphagia, Eosinophilia, Gastroesophageal reflux disease, Esophagogastroduodenoscopy
Abbreviations : EoE, GERD, EGD, PPI, 2 bottle Dif-EoE, 2 bottle Lim-EoE, 1 bottle-EoE, EREFS
Plan
| Sources of funding: None |
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| Content from this manuscript was presented at Digestive Disease Week in San Diego, CA May 2022. |
Vol 47 - N° 7
Article 102142- août 2023 Retour au numéro
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