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

Aliment Pharmacol Ther. 2013 Jan;37(1):114-21. doi: 10.1111/apt.12119. Epub 2012 Nov 5.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Deglutition Disorders / diagnosis
  • Deglutition Disorders / physiopathology
  • Eosinophilic Esophagitis / diagnosis*
  • Eosinophilic Esophagitis / drug therapy
  • Eosinophilic Esophagitis / physiopathology
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Male
  • Proton Pump Inhibitors / therapeutic use
  • Quality of Life*
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Time Factors
  • Young Adult

Substances

  • Glucocorticoids
  • Proton Pump Inhibitors