The natural history of eosinophilic oesophagitis in the transition from childhood to adulthood

Authors

  • P. Menard-Katcher,

    1. Division of Gastroenterology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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  • K. L. Marks,

    1. Division of Allergy and Immunology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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  • C. A. Liacouras,

    1. Division of Gastroenterology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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  • J. M. Spergel,

    1. Division of Allergy and Immunology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
    2. Division of Allergy and Immunology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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  • Y.-X. Yang,

    1. Division of Gastroenterology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
    2. Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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  • G. W. Falk

    Corresponding author
    • Division of Gastroenterology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Correspondence to:

Dr G. W. Falk, Division of Gastroenterology, Perelman School of Medicine at the University of Pennsylvania, 9th Floor Penn Tower, 1 Convention Center Avenue, Philadelphia, PA, USA.

E-mail: gary.falk@uphs.upenn.edu

Summary

Background

Eosinophilic oesophagitis (EoE) is a chronic inflammatory condition affecting both children and adults. Little is known about the natural history of EoE in the transition from childhood into adulthood.

Aim

To determine the prevalence of EoE symptoms and impact of EoE on quality of life among adults diagnosed with EoE during childhood.

Methods

This is a cross-sectional study of EoE patients from the Children's Hospital of Philadelphia EoE registry. Patients ≥18 years diagnosed with EoE during childhood were administered validated dysphagia [Mayo Dysphagia Questionnaire (MDQ)-30] and Quality of Life (PAGI-QOL) questionnaires. Ongoing EoE treatments were ascertained.

Results

A total of 140 EoE patients ≥18 years were identified; 53 completed all questions. Only 6 (11%) subjects had positive (n = 2) or indeterminate (n = 4) dysphagia scores. However, of 47 patients with negative scores, 18 (37%) reported ongoing difficulty swallowing. The mean PAGI-QOL score was 4.58/5. The dietary dimension score was 3.73/5. Current pharmacological EoE treatments were topical steroids (3/53) and interleukin-5 antagonists (3/53). Additionally, 26/53 (49%) were on PPI therapy and 40/53 (76%) were following allergy directed diets.

Conclusions

The majority of young adults diagnosed with EoE during childhood continue to require pharmacological treatment and/or dietary modification for EoE. A substantial proportion of this population experiences ongoing swallowing difficulties that a standard dysphagia questionnaire fails to capture. Dietary quality of life, but not total quality of life, appears to be adversely affected. These data suggest that EoE diagnosed during childhood remains a significant medical issue during early adulthood, and that better EoE symptom measurement instruments are needed.

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