Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Port Road, Adelaide, 5000, South Australia.
School of Medicine, University of Adelaide, Adelaide, 5000, South Australia.
Esophagus. 2022 Oct;19(4):554-559. doi: 10.1007/s10388-022-00924-7. Epub 2022 Jun 6.
Thickening of the esophageal wall in patients with eosinophilic esophagitis (EoE) and gastro-esophageal reflux disease (GERD) has been shown in studies using endoscopic ultrasound (EUS). We hypothesise that transmural inflammation in EoE results in prominent esophageal wall thickening compared with the mucosal inflammation in GERD. The aim of this study was to compare the relationship among dysphagia, endoscopic appearance, wall thickness, histology, and motility in EoE and GORD.
EoE and GERD patients were prospectively studied between February 2012 and April 2021. Patients were studied on 2 separate occasions with endoscopy, EUS and mucosal biopsies, followed by high-resolution manometry. Epidemiology and dysphagia data were obtained.
A total of 45 patients (31 EoE, 14 GERD) were included. There were no significant differences in age, sex, duration of disease and presence of esophageal motility disorders. EoE patients had a higher dysphagia score (P < 0.001), EREFS score (P < 0.001) and peak eosinophil count (P < 0.001) compared with GERD patients. Thickness of the submucosa in the distal esophagus in EoE was significantly higher than GERD (P = 0.003) and positively correlated with duration of disease (P = 0.01, R = 0.67). Positive correlation was also found between dysphagia score and distal total esophageal wall thickness (P = 0.03, R = 0.39) in EoE patients. No correlation was found between these variables in GERD patients.
Distal esophageal wall thickness positively correlates with dysphagia score in EoE but not GERD. This appears to be related to the composition of the submucosa which can be identified using EUS.
在使用内镜超声（EUS）的研究中，已经显示出嗜酸细胞性食管炎（EoE）和胃食管反流病（GERD）患者的食管壁增厚。我们假设 EoE 中的跨壁炎症导致食管壁增厚明显，而 GERD 中的黏膜炎症则不然。本研究旨在比较 EoE 和 GERD 患者的吞咽困难、内镜表现、壁厚度、组织学和运动之间的关系。
2012 年 2 月至 2021 年 4 月期间，前瞻性研究了 EoE 和 GERD 患者。患者在两次不同的内镜检查、EUS 和黏膜活检后进行了高分辨率测压，并获得了流行病学和吞咽困难数据。
共纳入 45 例患者（31 例 EoE，14 例 GERD）。EoE 患者和 GERD 患者在年龄、性别、疾病持续时间和食管运动障碍的存在方面无显著差异。EoE 患者的吞咽困难评分（P < 0.001）、EREFs 评分（P < 0.001）和嗜酸性粒细胞计数峰值（P < 0.001）均高于 GERD 患者。EoE 患者的远端食管黏膜下厚度明显高于 GERD（P = 0.003），且与疾病持续时间呈正相关（P = 0.01，R = 0.67）。EoE 患者的吞咽困难评分与远端食管总壁厚度也呈正相关（P = 0.03，R = 0.39）。而 GERD 患者中则未发现这些变量之间存在相关性。
EoE 患者的远端食管壁厚度与吞咽困难评分呈正相关，但 GERD 患者则不然。这似乎与 EUS 可识别的黏膜下成分有关。
