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.
Il testo completo di questo articolo è disponibile in 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
Mappa
| Sources of funding: None |
|
| Content from this manuscript was presented at Digestive Disease Week in San Diego, CA May 2022. |
Vol 47 - N° 7
Articolo 102142- Agosto 2023 Ritorno al numero
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