Topical corticosteroid treatment of dysphagia due to eosinophilic esophagitis in adults.
OBJECTIVE
To describe the clinical features of patients with eosinophilic esophagitis and the use of topical corticosteroids for treatment.


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 15 men and 6 women ranged in age from 27 years to 66 years at diagnosis (mean, 36 [corrected] 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.


CONCLUSIONS
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.
Arora
Amindra S
AS
Division of Gastroenterology and Hepatology and Internal Medicine, Mayo Clinic, Rochester, Minn 55905, USA. arora.amindra@mayo.edu
Perrault
Jean
J
Smyrk
Thomas C
TC
D000287:Administration, Topical; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D003680:Deglutition Disorders / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D004941:Esophagitis / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones