Topical corticosteroid treatment of dysphagia due to eosinophilic esophagitis in adults

Amindra S. Arora, Jean Perrault, Thomas Christopher Smyrk

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Abstract

Objective: To describe the clinical features of patients with eosinophilic esophagitis and the use of topical corticosteroids for treatment. Patients and Methods: We evaluated the charts of 21 patients with a diagnosis of eosinophilic esophagitis seen at the Mayo Clinic in Rochester, Minn, between September 1, 1999, and December 31, 2001. The diagnosis was based on the presence of a "ringed esophagus" or a tapered distal esophagus on upper endoscopy as well as the presence of a dense eosinophilic infiltrate on esophageal biopsy. All patients were treated with topical corticosteroids, and follow-up was performed by telephone interviews. Results: The 17 men and 4 women ranged in age from 28 years to 55 years at diagnosis (mean, 40 years). All had solid-food dysphagia for at least 6 years, and 15 patients had prior food impaction. Eighteen patients had either a ringed-appearing esophagus or smooth tapering in the distal esophagus. All patients had a dense eosinophilic infiltration (>20 eosinophils per high-power field) in the mid or distal esophagus. Topical corticosteroid therapy for 6 weeks resulted in complete dysphagia relief in all patients and lasted a minimum of 4 months. Conclusion: Eosinophilic esophagitis is an entity associated with food dysphagia (predominantly in young adults) and a ringed or smooth tapered distal-appearing esophagus. Our study found no association with gastroesophageal reflux symptoms. Topical corticosteroid therapy was effective.

Original languageEnglish (US)
Pages (from-to)830-835
Number of pages6
JournalMayo Clinic Proceedings
Volume78
Issue number7
StatePublished - Jul 1 2003

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Eosinophilic Esophagitis
Deglutition Disorders
Adrenal Cortex Hormones
Esophagus
Therapeutics
Food
Gastroesophageal Reflux
Eosinophils
Endoscopy
Young Adult
Interviews
Biopsy

ASJC Scopus subject areas

  • Medicine(all)

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Topical corticosteroid treatment of dysphagia due to eosinophilic esophagitis in adults. / Arora, Amindra S.; Perrault, Jean; Smyrk, Thomas Christopher.

In: Mayo Clinic Proceedings, Vol. 78, No. 7, 01.07.2003, p. 830-835.

Research output: Contribution to journalArticle

Arora, AS, Perrault, J & Smyrk, TC 2003, 'Topical corticosteroid treatment of dysphagia due to eosinophilic esophagitis in adults', Mayo Clinic Proceedings, vol. 78, no. 7, pp. 830-835.
Arora, Amindra S. ; Perrault, Jean ; Smyrk, Thomas Christopher. / Topical corticosteroid treatment of dysphagia due to eosinophilic esophagitis in adults. In: Mayo Clinic Proceedings. 2003 ; Vol. 78, No. 7. pp. 830-835.
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