title: Changing epidemiology of food bolus impaction: is eosinophilic esophagitis to blame?
abstract: OBJECTIVE
  Data on the relationship between epidemiological changes in food bolus impaction (FBI) and its relationship to eosinophilic esophagitis (EoE) are limited. The aim of this study was to evaluate changes in the prevalence and etiology of FBI at the Royal Adelaide Hospital over 15 years.
  
  
  METHODS
  Details of all patients who presented with FBI to Royal Adelaide Hospital (1996-2010) were reviewed from a prospective database. Detailed endoscopic and histological findings were examined for patients admitted under the Gastroenterology team.
  
  
  RESULTS
  From 1996-2010, 539 patients were admitted. Prevalence of FBI increased overtime, with a male preponderance. The age at presentation was significantly lower in 2006-2010 (56.2 ± 1.6 years) compared with 2001-2005 (61.6 ± 1.9 years, P=0.03). There was a reduction in the proportion of patients with peptic-related stricture (from 75% [1996-2000] to 41% [2006-2010] [P<0.001]) and an increase in the prevalence of EoE (from 0% [1996-2000] to 35% [2006-2010], P<0.001). The proportion of patients who had esophageal biopsies taken at the index endoscopy also increased (8% [1996-2000] vs 28% [2001-2005] and 61% [2006-2010], P<0.01). There were no significant changes in rate of malignancy or post-surgical strictures. Endoscopic removal of food bolus was required in 86% of cases and, of these, 98% were successful with no complication or death.
  
  
  CONCLUSIONS
  The prevalence of FBI has increased over the last 15 years. This was associated with an increased prevalence of EoE and a reduction in age of presentation and peptic-related strictures. These findings suggest that EoE is an important cause of FBI and that esophageal mucosal biopsy should be performed in all cases of FBI.
authors: Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Australia.
authors: Venkat N
authors: VN
authors: Mahesh
authors: Richard H
authors: RH
authors: Holloway
authors: Nam Quoc
authors: NQ
authors: Nguyen
mesh_terms: D057765:Eosinophilic Esophagitis / Q000150:complications*; D004935:Esophageal Diseases / Q000453:epidemiology / Q000209:etiology; D004947:Esophagus; D005260:Female; D005502:Food; D005766:Gastrointestinal Contents; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies; D013997:Time Factors