Epidemiology of eosinophilic esophagitis over three decades in Olmsted County, Minnesota.
OBJECTIVE
Data on secular trends and outcomes of eosinophilic esophagitis (EE) are scarce. We performed a population-based study to assess the epidemiology and outcomes of EE in Olmsted County, Minnesota, over the last 3 decades.


METHODS
All cases of EE diagnosed between 1976 and 2005 were identified using the Rochester Epidemiology Project resources. Esophageal biopsies with any evidence of esophagitis and/or eosinophilic infiltration were reviewed by a single pathologist. Clinical course (treatment, response, and recurrence) was defined using information collected from medical records and prospectively via a telephone questionnaire. Incidence rates per 100,000 person years were directly adjusted for age and sex to the US 2000 population structure.


RESULTS
A total of 78 patients with EE were identified. The incidence of EE increased significantly over the last 3 of the 5-year intervals (from 0.35 [95% confidence interval (CI)], 0-0.87] per 100,000 person-years during 1991-1995 to 9.45 [95% CI, 7.13-11.77] per 100,000 person-years during 2001-2005). The prevalence of EE was 55.0 (95% CI, 42.7-67.2) per 100,000 persons as of January 1, 2006, in Olmsted County, Minnesota. EE was diagnosed more frequently in late summer/fall. The clinical course of patients with EE was characterized by recurrent symptoms (observed in 41% of patients).


CONCLUSIONS
The prevalence and incidence of EE is higher than previously reported. The incidence of clinically diagnosed EE increased significantly over the last 3 decades, in parallel with endoscopy volume. Seasonal incidence was greatest in late summer and fall. EE also appears to be a recurrent relapsing disease in a substantial proportion of patients.
Prasad
Ganapathy A
GA
Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
Alexander
Jeffery A
JA
Schleck
Cathy D
CD
Zinsmeister
Alan R
AR
Smyrk
Thomas C
TC
Elias
Richard M
RM
Locke
G Richard
GR
Talley
Nicholas J
NJ
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004804:Eosinophils / Q000473:pathology*; D004941:Esophagitis / Q000453:epidemiology* / Q000473:pathology* / Q000503:physiopathology; D004947:Esophagus / Q000473:pathology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D015995:Prevalence; D012008:Recurrence; D012621:Seasons; D011795:Surveys and Questionnaires