TY - JOUR
T1 - Food-induced immediate response of the esophagus—A newly identified syndrome in patients with eosinophilic esophagitis
AU - Biedermann, Luc
AU - Holbreich, Mark
AU - Atkins, Dan
AU - Chehade, Mirna
AU - Dellon, Evan S.
AU - Furuta, Glenn T.
AU - Hirano, Ikuo
AU - Gonsalves, Nirmala
AU - Greuter, Thomas
AU - Gupta, Sandeep
AU - Katzka, David A.
AU - De Rooij, Willemijn
AU - Safroneeva, Ekaterina
AU - Schoepfer, Alain
AU - Schreiner, Philipp
AU - Simon, Dagmar
AU - Simon, Hans Uwe
AU - Warners, Marijn
AU - Bredenoord, Albert Jan
AU - Straumann, Alex
N1 - Publisher Copyright:
© 2020 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.
PY - 2021/1
Y1 - 2021/1
N2 - Background: Dysphagia is the main symptom of adult eosinophilic esophagitis (EoE). We describe a novel syndrome, referred to as “food-induced immediate response of the esophagus” (FIRE), observed in EoE patients. Methods: Food-induced immediate response of the esophagus is an unpleasant/painful sensation, unrelated to dysphagia, occurring immediately after esophageal contact with specific foods. Eosinophilic esophagitis experts were surveyed to estimate the prevalence of FIRE, characterize symptoms, and identify food triggers. We also surveyed a large group of EoE patients enrolled in the Swiss EoE Cohort Study for FIRE. Results: Response rates were 82% (47/57) for the expert and 65% (239/368) for the patient survey, respectively. Almost, 90% of EoE experts had observed the FIRE symptom complex in their patients. Forty percent of EoE patients reported experiencing FIRE, more commonly in patients who developed EoE symptoms at a younger age (mean age of 46.4 years vs 54.1 years without FIRE; P <.01) and in those with high allergic comorbidity. Food-induced immediate response of the esophagus symptoms included narrowing, burning, choking, and pressure in the esophagus appearing within 5 minutes of ingesting a provoking food that lasted less than 2 hours. Symptom severity rated a median 7 points on a visual analogue scale from 1 to 10. Fresh fruits/vegetables and wine were the most frequent triggers. Endoscopic food removal was significantly more commonly reported in male patients with vs without FIRE (44.3% vs 27.6%; P =.03). Conclusions: Food-induced immediate response of the esophagus is a novel syndrome frequently reported in EoE patients, characterized by an intense, unpleasant/painful sensation occurring rapidly and reproducibly in 40% of surveyed EoE patients after esophageal contact with specific foods.
AB - Background: Dysphagia is the main symptom of adult eosinophilic esophagitis (EoE). We describe a novel syndrome, referred to as “food-induced immediate response of the esophagus” (FIRE), observed in EoE patients. Methods: Food-induced immediate response of the esophagus is an unpleasant/painful sensation, unrelated to dysphagia, occurring immediately after esophageal contact with specific foods. Eosinophilic esophagitis experts were surveyed to estimate the prevalence of FIRE, characterize symptoms, and identify food triggers. We also surveyed a large group of EoE patients enrolled in the Swiss EoE Cohort Study for FIRE. Results: Response rates were 82% (47/57) for the expert and 65% (239/368) for the patient survey, respectively. Almost, 90% of EoE experts had observed the FIRE symptom complex in their patients. Forty percent of EoE patients reported experiencing FIRE, more commonly in patients who developed EoE symptoms at a younger age (mean age of 46.4 years vs 54.1 years without FIRE; P <.01) and in those with high allergic comorbidity. Food-induced immediate response of the esophagus symptoms included narrowing, burning, choking, and pressure in the esophagus appearing within 5 minutes of ingesting a provoking food that lasted less than 2 hours. Symptom severity rated a median 7 points on a visual analogue scale from 1 to 10. Fresh fruits/vegetables and wine were the most frequent triggers. Endoscopic food removal was significantly more commonly reported in male patients with vs without FIRE (44.3% vs 27.6%; P =.03). Conclusions: Food-induced immediate response of the esophagus is a novel syndrome frequently reported in EoE patients, characterized by an intense, unpleasant/painful sensation occurring rapidly and reproducibly in 40% of surveyed EoE patients after esophageal contact with specific foods.
KW - clinical symptoms
KW - eosinophilic esophagitis (EoE)
KW - food-induced immediate response of the esophagus (FIRE)
KW - immediate response
KW - oral allergy syndrome
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U2 - 10.1111/all.14495
DO - 10.1111/all.14495
M3 - Article
C2 - 32662110
AN - SCOPUS:85089496338
SN - 0105-4538
VL - 76
SP - 339
EP - 347
JO - Allergy: European Journal of Allergy and Clinical Immunology
JF - Allergy: European Journal of Allergy and Clinical Immunology
IS - 1
ER -