title: The natural history of eosinophilic oesophagitis in the transition from childhood to adulthood.
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.
  
  
  OBJECTIVE
  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.
authors.affiliation: Division of Gastroenterology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA.
authors.forename: P
authors.initials: P
authors.lastname: Menard-Katcher
authors.forename: K L
authors.initials: KL
authors.lastname: Marks
authors.forename: C A
authors.initials: CA
authors.lastname: Liacouras
authors.forename: J M
authors.initials: JM
authors.lastname: Spergel
authors.forename: Y-X
authors.initials: YX
authors.lastname: Yang
authors.forename: G W
authors.initials: GW
authors.lastname: Falk
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003680:Deglutition Disorders / Q000175:diagnosis / Q000503:physiopathology; D057765:Eosinophilic Esophagitis / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D054328:Proton Pump Inhibitors