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Food-induced immediate response of the esophagus-A newly identified syndrome in patients with eosinophilic esophagitis.

Abstract：

BACKGROUND:Dysphagia is the main symptom of adult eosinophilic esophagitis (EoE). We describe a novel syndrome, referred to as "food-induced immediate response of the esophagus" (FIRE), observed in EoE patients. METHODS:Food-induced immediate response of the esophagus is an unpleasant/painful sensation, unrelated to dysphagia, occurring immediately after esophageal contact with specific foods. Eosinophilic esophagitis experts were surveyed to estimate the prevalence of FIRE, characterize symptoms, and identify food triggers. We also surveyed a large group of EoE patients enrolled in the Swiss EoE Cohort Study for FIRE. RESULTS:Response rates were 82% (47/57) for the expert and 65% (239/368) for the patient survey, respectively. Almost, 90% of EoE experts had observed the FIRE symptom complex in their patients. Forty percent of EoE patients reported experiencing FIRE, more commonly in patients who developed EoE symptoms at a younger age (mean age of 46.4 years vs 54.1 years without FIRE; P < .01) and in those with high allergic comorbidity. Food-induced immediate response of the esophagus symptoms included narrowing, burning, choking, and pressure in the esophagus appearing within 5 minutes of ingesting a provoking food that lasted less than 2 hours. Symptom severity rated a median 7 points on a visual analogue scale from 1 to 10. Fresh fruits/vegetables and wine were the most frequent triggers. Endoscopic food removal was significantly more commonly reported in male patients with vs without FIRE (44.3% vs 27.6%; P = .03). CONCLUSIONS:Food-induced immediate response of the esophagus is a novel syndrome frequently reported in EoE patients, characterized by an intense, unpleasant/painful sensation occurring rapidly and reproducibly in 40% of surveyed EoE patients after esophageal contact with specific foods.

journal_name

Allergy

journal_title

Allergy

authors

Biedermann L,Holbreich M,Atkins D,Chehade M,Dellon ES,Furuta GT,Hirano I,Gonsalves N,Greuter T,Gupta S,Katzka DA,De Rooij W,Safroneeva E,Schoepfer A,Schreiner P,Simon D,Simon HU,Warners M,Bredenoord AJ,Straumann A

doi

10.1111/all.14495

subject

Has Abstract

pub_date

2021-01-01 00:00:00

pages

339-347

issue

eissn

0105-4538

issn

1398-9995

journal_volume

pub_type

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Food-induced immediate response of the esophagus-A newly identified syndrome in patients with eosinophilic esophagitis.