Abstract
Background Eosinophilic esophagitis (EoE) is a chronic immune/antigen- mediated disease with esophageal dysfunction and eosinophil-predominant inflammation. An association between EoE and gastro-esophageal reflux disease (GERD) has not been well established. Aims The aim was to evaluate patients with EoE who underwent pH-Multichannel Intraluminal Impedance (pH-MII), investigating proton-pump-inhibitors (PPI) therapy/anti-reflux surgery requirement. Methods Twenty-five patients [mean age 7.6 (range 1-17 years)] with EoE underwent pH-MII. The children were then divided into Group 1 (pathological pH-MII) and Group 2 (normal pH-MII). PPI was administered for two months in Group 1 and in those children in Group 2 unresponsive to standard EoE therapy (diet and corticosteroids). All patients underwent endoscopy and clinical follow-up. Data are described as mean (range). Results Group 1 (n = 16, M:F = 14:2) had mean reflux index (RI) 13.9% (0.8%-53.4%) with a mean number of total reflux episodes (RE) of 65.8 (14-341). Group 2 (n = 9, M:F = 6:3) had a mean RI 1.2% (0.2%-2.7%) with a mean number of total RE of 27.4 (14-39). There was a histological response to repeated cycles of PPI in 11/16 (69%) children in Group 1 and 4/9 (44%) children in Group 2. Fundoplication, because of dependence on PPI, was required in 4/11 PPI-responders in Group 1, allowing discontinuation without relapse of EoE. Conclusions The use of PPI is suggested in EoE at time of diagnosis in addition to standard treatment and may even have benefit in children who do not appear to have significant GERD but are unresponsive to standard therapy.
| Original language | English |
|---|---|
| Pages (from-to) | 304-308 |
| Number of pages | 5 |
| Journal | Journal of Pediatric Surgery |
| Volume | 48 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Feb 2013 |
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Keywords
- Antireflux surgery
- Eosinophilic esophagitis
- Gastro Esophageal Reflux Disease (GERD)
- Proton pump Inhibitors
ASJC Scopus subject areas
- Surgery
- Pediatrics, Perinatology, and Child Health
Cite this
Eosinophilic esophagitis : Is it also a surgical disease? / Rea, Francesca; Caldaro, Tamara; Tambucci, Renato; Romeo, Erminia F.; Caloisi, Claudia; Torroni, Filippo; Di Abriola, Giovanni Federici; Foschia, Francesca; Francalanci, Paola; Dall'Oglio, Luigi; De Angelis, Paola.
In: Journal of Pediatric Surgery, Vol. 48, No. 2, 02.2013, p. 304-308.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Eosinophilic esophagitis
T2 - Is it also a surgical disease?
AU - Rea, Francesca
AU - Caldaro, Tamara
AU - Tambucci, Renato
AU - Romeo, Erminia F.
AU - Caloisi, Claudia
AU - Torroni, Filippo
AU - Di Abriola, Giovanni Federici
AU - Foschia, Francesca
AU - Francalanci, Paola
AU - Dall'Oglio, Luigi
AU - De Angelis, Paola
PY - 2013/2
Y1 - 2013/2
N2 - Background Eosinophilic esophagitis (EoE) is a chronic immune/antigen- mediated disease with esophageal dysfunction and eosinophil-predominant inflammation. An association between EoE and gastro-esophageal reflux disease (GERD) has not been well established. Aims The aim was to evaluate patients with EoE who underwent pH-Multichannel Intraluminal Impedance (pH-MII), investigating proton-pump-inhibitors (PPI) therapy/anti-reflux surgery requirement. Methods Twenty-five patients [mean age 7.6 (range 1-17 years)] with EoE underwent pH-MII. The children were then divided into Group 1 (pathological pH-MII) and Group 2 (normal pH-MII). PPI was administered for two months in Group 1 and in those children in Group 2 unresponsive to standard EoE therapy (diet and corticosteroids). All patients underwent endoscopy and clinical follow-up. Data are described as mean (range). Results Group 1 (n = 16, M:F = 14:2) had mean reflux index (RI) 13.9% (0.8%-53.4%) with a mean number of total reflux episodes (RE) of 65.8 (14-341). Group 2 (n = 9, M:F = 6:3) had a mean RI 1.2% (0.2%-2.7%) with a mean number of total RE of 27.4 (14-39). There was a histological response to repeated cycles of PPI in 11/16 (69%) children in Group 1 and 4/9 (44%) children in Group 2. Fundoplication, because of dependence on PPI, was required in 4/11 PPI-responders in Group 1, allowing discontinuation without relapse of EoE. Conclusions The use of PPI is suggested in EoE at time of diagnosis in addition to standard treatment and may even have benefit in children who do not appear to have significant GERD but are unresponsive to standard therapy.
AB - Background Eosinophilic esophagitis (EoE) is a chronic immune/antigen- mediated disease with esophageal dysfunction and eosinophil-predominant inflammation. An association between EoE and gastro-esophageal reflux disease (GERD) has not been well established. Aims The aim was to evaluate patients with EoE who underwent pH-Multichannel Intraluminal Impedance (pH-MII), investigating proton-pump-inhibitors (PPI) therapy/anti-reflux surgery requirement. Methods Twenty-five patients [mean age 7.6 (range 1-17 years)] with EoE underwent pH-MII. The children were then divided into Group 1 (pathological pH-MII) and Group 2 (normal pH-MII). PPI was administered for two months in Group 1 and in those children in Group 2 unresponsive to standard EoE therapy (diet and corticosteroids). All patients underwent endoscopy and clinical follow-up. Data are described as mean (range). Results Group 1 (n = 16, M:F = 14:2) had mean reflux index (RI) 13.9% (0.8%-53.4%) with a mean number of total reflux episodes (RE) of 65.8 (14-341). Group 2 (n = 9, M:F = 6:3) had a mean RI 1.2% (0.2%-2.7%) with a mean number of total RE of 27.4 (14-39). There was a histological response to repeated cycles of PPI in 11/16 (69%) children in Group 1 and 4/9 (44%) children in Group 2. Fundoplication, because of dependence on PPI, was required in 4/11 PPI-responders in Group 1, allowing discontinuation without relapse of EoE. Conclusions The use of PPI is suggested in EoE at time of diagnosis in addition to standard treatment and may even have benefit in children who do not appear to have significant GERD but are unresponsive to standard therapy.
KW - Antireflux surgery
KW - Eosinophilic esophagitis
KW - Gastro Esophageal Reflux Disease (GERD)
KW - Proton pump Inhibitors
UR - http://www.scopus.com/inward/record.url?scp=84873657302&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84873657302&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2012.11.006
DO - 10.1016/j.jpedsurg.2012.11.006
M3 - Article
C2 - 23414856
AN - SCOPUS:84873657302
VL - 48
SP - 304
EP - 308
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 2
ER -