Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
Department of Endoscopy, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
Dig Dis Sci. 2021 Jul;66(7):2291-2300. doi: 10.1007/s10620-020-06527-5. Epub 2020 Aug 8.
Endoscopic ultrasonography (EUS) and high-resolution manometry (HRM) can be used in the evaluation of eosinophilic esophagitis (EoE) for frequent symptoms such as dysphagia. However, the role of these examinations is not clear.
The aim of this study was to objectively evaluate the subjective symptoms of EoE patients with EUS and HRM.
Patients who had endoscopic findings indicative of EoE and matched the number of eosinophil infiltrates used as diagnostic criteria were recruited between September 2018 and August 2019. Evaluable subjects underwent EUS and HRM and completed the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire. The esophageal wall thickness (evaluated with EUS) and HRM parameters between patients with and without symptoms were retrospectively compared. Symptomatic patients were re-examined using EUS and HRM 6 months after treatment.
A total of 35 patients (29 males, median age of 49 years) were divided into symptomatic (20 patients) and asymptomatic groups (15 patients). The esophageal wall was thicker, and the distal contractile integral (DCI) values were higher in the symptomatic group (P < 0.001). In addition, DCI values were positively correlated with esophageal wall thickness. After treatment, the GSRS scores showed an improving trend for each item. Esophageal wall thickness and DCI values were significantly decreased (Ps < 0.001).
Esophageal wall thickening and increased esophageal body pressure may be involved in subjective symptoms. In addition, treatment may reduce esophageal thickness and pressure along with improvement of subjective symptoms.
内镜超声检查（EUS）和高分辨率测压（HRM）可用于评估嗜酸性食管炎（EoE）患者的频繁症状，如吞咽困难。然而，这些检查的作用尚不清楚。
本研究旨在客观评估 EoE 患者的 EUS 和 HRM 主观症状。
2018 年 9 月至 2019 年 8 月期间，招募了内镜下表现为 EoE 并符合作为诊断标准的嗜酸性粒细胞浸润数量的患者。可评估的受试者接受了 EUS 和 HRM，并完成了胃肠道症状评分量表（GSRS）问卷。回顾性比较了有症状和无症状患者之间的食管壁厚度（通过 EUS 评估）和 HRM 参数。治疗 6 个月后，对有症状的患者再次进行 EUS 和 HRM 检查。
共有 35 名患者（29 名男性，中位年龄 49 岁）分为有症状组（20 名患者）和无症状组（15 名患者）。有症状组的食管壁较厚，远端收缩积分（DCI）值较高（P<0.001）。此外，DCI 值与食管壁厚度呈正相关。治疗后，GSRS 评分各项目呈改善趋势。食管壁厚度和 DCI 值显著降低（均 P<0.001）。
食管壁增厚和食管体压升高可能与主观症状有关。此外，治疗可能会降低食管厚度和压力，同时改善主观症状。
