Abstract：
BACKGROUND: There is a complex interrelationship between gastroesophageal reflux disease (GERD) and eosinophilic esophagitis (EoE) potentially promoting the occurrence and modulating severity of each other reciprocally. Presence of Barrett\'s esophagus (BE) is a defining factor for the diagnosis of GERD. While several studies investigated the potential impact of concomitant GERD on the presentation and course of EoE, little was known with regards to BE in EoE patients.
METHODS: We analyzed prospectively collected clinical, endoscopic, and histological data from patients enrolled in the Swiss Eosinophilic Esophagitis Cohort Study (SEECS) regarding differences between EoE patients with (EoE/BE+) versus without BE (EoE/BE-) and determined the prevalence of BE in EoE patients.
RESULTS: Among a total of 509 EoE patients included in our analysis, 24 (4.7%) had concomitant BE with a high male preponderance (EoE/BE+ 83.3% vs. EoE/BE- 74.4%). While there were no differences in dysphagia, odynophagia was significantly (12.5 vs. 3.1%, p = 0.047) more common in EoE/BE+ versus EoE/BE-. General well-being at last follow-up was significantly lower in EoE/BE+. Endoscopically, we observed an increased incidence of fixed rings in the proximal esophagus in EoE/BE+ (70.8 vs. 46.3% in EoE/BE-, p = 0.019) and a higher fraction of patients with a severe fibrosis in the proximal histological specimen (8.7 vs. 1.6% in EoE/BE, p = 0.017).
CONCLUSIONS: Our study reveals that BE is twice as frequent in EoE patients compared to general population. Despite many similarities between EoE patients with and without BE, the finding of a more pronounced remodeling in EoE patients with Barrett is noteworthy.
METHODS: We analyzed prospectively collected clinical, endoscopic, and histological data from patients enrolled in the Swiss Eosinophilic Esophagitis Cohort Study (SEECS) regarding differences between EoE patients with (EoE/BE+) versus without BE (EoE/BE-) and determined the prevalence of BE in EoE patients.
RESULTS: Among a total of 509 EoE patients included in our analysis, 24 (4.7%) had concomitant BE with a high male preponderance (EoE/BE+ 83.3% vs. EoE/BE- 74.4%). While there were no differences in dysphagia, odynophagia was significantly (12.5 vs. 3.1%, p = 0.047) more common in EoE/BE+ versus EoE/BE-. General well-being at last follow-up was significantly lower in EoE/BE+. Endoscopically, we observed an increased incidence of fixed rings in the proximal esophagus in EoE/BE+ (70.8 vs. 46.3% in EoE/BE-, p = 0.019) and a higher fraction of patients with a severe fibrosis in the proximal histological specimen (8.7 vs. 1.6% in EoE/BE, p = 0.017).
CONCLUSIONS: Our study reveals that BE is twice as frequent in EoE patients compared to general population. Despite many similarities between EoE patients with and without BE, the finding of a more pronounced remodeling in EoE patients with Barrett is noteworthy.
摘要：
背景：胃食管反流病（GERD）和嗜酸性粒细胞性食管炎（EoE）之间存在复杂的相互关系，可能相互促进发生并调节严重程度。Barrett食管（BE）的存在是GERD诊断的决定性因素。虽然一些研究调查了伴随GERD对EoE的表现和病程的潜在影响，对EoE患者的BE知之甚少。
方法：我们分析了前瞻性收集的临床，来自瑞士嗜酸细胞性食管炎队列研究（SEECS）的患者的内镜和组织学数据，关于EoE患者（EoE/BE）与不含BE(EoE/BE-)，并确定EoE患者中BE的患病率。
结果：在我们的分析中纳入了509例EoE患者，24例（4.7％）合并有较高的男性优势（EoE/BE83.3％vsEoE/BE-74.4％）。虽然吞咽困难没有差异，食欲不振显着（12.5vs.3.1%,p=0.047）在EoE/BE+与EoE/BE-。EoE/BE+患者末次随访时的总体幸福感明显较低。在内镜下，我们观察到EoE/BE+中近端食管固定环的发生率增加（70.8%vs.46.3%的EoE/BE-，p=0.019），并且在近端组织学标本中严重纤维化的患者比例更高（8.7％vs.1.6%的EoE/BE，p=0.017)。
结论：我们的研究表明，与一般人群相比，EoE患者的BE频率是一般人群的两倍。尽管有和没有Barrett食管的EoE患者之间有许多相似之处，值得注意的是,在使用Barrett的EoE患者中发现更明显的重塑.
方法：我们分析了前瞻性收集的临床，来自瑞士嗜酸细胞性食管炎队列研究（SEECS）的患者的内镜和组织学数据，关于EoE患者（EoE/BE）与不含BE(EoE/BE-)，并确定EoE患者中BE的患病率。
结果：在我们的分析中纳入了509例EoE患者，24例（4.7％）合并有较高的男性优势（EoE/BE83.3％vsEoE/BE-74.4％）。虽然吞咽困难没有差异，食欲不振显着（12.5vs.3.1%,p=0.047）在EoE/BE+与EoE/BE-。EoE/BE+患者末次随访时的总体幸福感明显较低。在内镜下，我们观察到EoE/BE+中近端食管固定环的发生率增加（70.8%vs.46.3%的EoE/BE-，p=0.019），并且在近端组织学标本中严重纤维化的患者比例更高（8.7％vs.1.6%的EoE/BE，p=0.017)。
结论：我们的研究表明，与一般人群相比，EoE患者的BE频率是一般人群的两倍。尽管有和没有Barrett食管的EoE患者之间有许多相似之处，值得注意的是,在使用Barrett的EoE患者中发现更明显的重塑.
