title: The incidence of esophageal bolus impaction: is there a seasonal variation?
abstract: OBJECTIVE
  Eosinophilic esophagitis is a disease associated with dysphagia and has a seasonal variation in incidence. The primary aim of this study was to search for a potential seasonal variation in the incidence of esophageal foreign bodies or food impaction. In addition, after exclusion of structural or accidental causes, the authors sought to explore if such a variation would differ between patients with or without atopic disorders.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  NÄL Medical Centre Hospital, a secondary referral hospital.
  
  
  METHODS
  A total of 314 consecutive cases of esophageal bolus impaction from 2004 through 2009 were included and analyzed regarding seasonal variation in incidence. The analysis was repeated after exclusion of cases with sharp items, cancer, or atresia and again separately after subdividing this group according to presence of atopy.
  
  
  RESULTS
  The overall incidence of esophageal bolus impaction was significantly higher during summer and fall than during the corresponding winter and spring period. In cases with atopic disorders and soft foods or meat bolus obstruction (n = 90), the incidence during the fall was significantly higher than that during the winter, and the incidence during the summer and fall was significantly higher than the corresponding incidence during the winter and spring. This variation was not present in patients without any signs or symptoms of atopy.
  
  
  CONCLUSIONS
  There was a significant seasonal variation in the incidence of acute esophageal bolus impaction. This variation was pronounced in patients with a coexisting atopic diathesis but was nonsignificant in patients without atopy.
authors.affiliation: Department of ENT & Maxillofacial Surgery, NÄL Medical Centre Hospital, Trollhättan, Sweden.
authors.forename: Helen
authors.initials: H
authors.lastname: Larsson
authors.forename: Henrik
authors.initials: H
authors.lastname: Bergquist
authors.forename: Mogens
authors.initials: M
authors.lastname: Bove
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003680:Deglutition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D003937:Diagnosis, Differential; D057765:Eosinophilic Esophagitis / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D004940:Esophageal Stenosis / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D004947:Esophagus; D005260:Female; D005547:Foreign Bodies / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012621:Seasons; D017678:Sex Distribution; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult