Topical Corticosteroid Treatment of Dysphagia Due to Eosinophilic Esophagitis in Adults

Arora, Amindra S.; Perrault, Jean; Smyrk, Thomas C.
July 2003
Mayo Clinic Proceedings;Jul2003, Vol. 78 Issue 7, p830
Academic Journal
• Objective: To describe the clinical features of patients with eosinophilic esophagitis and the use of topical corticosteroids for treatment. • Patients and 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 17 men and 4 women ranged in age from 28 years to 55 years at diagnosis (mean, 40 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. • Conclusion: 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.


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