Center for Esophageal Diseases and Swallowing.
Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine.
Dis Esophagus. 2019 Nov 13;32(9). doi: 10.1093/dote/doz028.
Non-dysphagia symptoms, such as heartburn and dyspepsia, are poorly characterized in adults with eosinophilic esophagitis (EoE). It is unclear if treatment improves these symptoms. The aim of this paper was to assess (i) heartburn and dyspepsia symptom severity in adult EoE patients using validated symptom measures; (ii) change in symptoms after treatment; and (iii) symptom association with endoscopic and histologic features. In a prospective cohort of adult EoE patients who were not responsive to proton pump inhibitor therapy, non-dysphagia symptoms were assessed with heartburn items from the validated GERD-HRQL (gastroesophageal reflux disease health-related quality of life) and SODA (severity of dyspepsia assessment) instruments. Subjects completed the questionnaires at baseline and after treatment. Association of baseline symptoms with endoscopic and histologic features, and before and after treatment with diet or topical steroids, was assessed. Eighty-six EoE patients (mean age 39 years, 57% male, 95% white) completed a baseline questionnaire and 62 completed the follow-up questionnaire. The mean baseline GERD-HRQL score was 4.5 ± 6.5 and the mean total SODA score was 41.0 ± 12.6. At baseline, there was a weak but significant correlation between peak eosinophils and the SODA score (r = 0.28; p = 0.03) and no association between heartburn and SODA scores and endoscopic or other histologic findings. After treatment, there was a decrease in GERD-HRQL heartburn (4.3 vs. 2.6; p = 0.04) and SODA (49.5 vs. 35.5; p = 0.04) scores in histologic responders, but not in nonresponders. In a prospective cohort of EoE patients, baseline eosinophils positively correlated with dyspepsia severity. Heartburn and dyspepsia symptoms improved after treatment in histologic responders.
非吞咽困难症状，如烧心和消化不良，在嗜酸性粒细胞性食管炎（EoE）成人患者中描述不佳。尚不清楚治疗是否能改善这些症状。本文的目的是评估（i）使用经过验证的症状量表评估成人 EoE 患者烧心和消化不良症状的严重程度；（ii）治疗后症状的变化；以及（iii）症状与内镜和组织学特征的关系。在一项质子泵抑制剂治疗反应不佳的成人 EoE 患者前瞻性队列中，使用经过验证的 GERD-HRQL（胃食管反流病相关生活质量）和 SODA（消化不良严重程度评估）量表中的烧心项目评估非吞咽困难症状。患者在基线和治疗后完成问卷。评估基线症状与内镜和组织学特征以及饮食或局部类固醇治疗前后的关系。86 例 EoE 患者（平均年龄 39 岁，57%为男性，95%为白人）完成了基线问卷，62 例完成了随访问卷。GERD-HRQL 量表的平均基线评分为 4.5 ± 6.5，SODA 量表的平均总分为 41.0 ± 12.6。基线时，SODA 评分与食管嗜酸性粒细胞峰值之间存在弱但有统计学意义的相关性（r = 0.28；p = 0.03），而烧心与 SODA 评分以及内镜或其他组织学发现之间无相关性。治疗后，组织学反应者的 GERD-HRQL 烧心（4.3 对 2.6；p = 0.04）和 SODA（49.5 对 35.5；p = 0.04）评分降低，但非反应者无变化。在 EoE 患者的前瞻性队列中，基线嗜酸性粒细胞与消化不良严重程度呈正相关。组织学反应者治疗后烧心和消化不良症状改善。
