Title: THE ROLE OF NON-ACID REFLUX IN PATIENTS WITH EOSINOPHILIC ESOPHAGITIS: A STUDY USING MULTI-CHANNEL INTRALUMINAL IMPEDANCE (PH-MII)
Abstract: Background: Eosinophilic esophagitis (EE) is a clinicopathological disease that typically affects the proximal and distal esophagus. Clinical evidence suggests a role for food or aero-allergens, but the impact of non-acid reflux in patients with EE is uncertain. Aim: To determine whether non-acid reflux is increased in patients with EE. Methods: This is a retrospective study in which pH-MII tracings of children with well-defined clinicopathological features of EE were compared to children with GERD and patients with no evidence of pathologic reflux (controls). GERD patients had reflux symptoms in addition to abnormal pH recordings with a reflux index >6%. Children with EE had a normal pH probe and demonstrated esophageal eosinophilia (>20 eos/HPF) that did not respond to 8 weeks of proton pump inhibition. Patients referred for evaluation of respiratory symptoms with normal esophageal biopsies, a normal pH probe, and no symptoms of GERD were used as controls. Reflux profiles were compared using ANOVA. Results: Consecutive pH-MII tracings from 10 patients with EE, 10 patients with GERD and 9 controls were reviewed. Results are shown (mean ± std) in the table below. No statistically significant differences were found between EE patients compared to controls. Patients with GERD had significantly more acid and pH-only reflux compared to EE and controls.TABLEConclusions: Non-acid reflux does not seem to play a role in the pathogenesis of EE. Antigenic stimulation may occur during initial topical passage of foodstuffs/aeroallergens or as a result of systemic exposure rather than during reflux.
Publication Year: 2005
Publication Date: 2005-10-01
Language: en
Type: article
Indexed In: ['crossref']
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Cited By Count: 3
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