Is Eosinophilic Esophagitis More Frequent in Patients with Inflammatory Bowel Disease?

A Sonnenberg et al. Clin Gastroenterol Hepatol 2021; 19: 613-615. Full Text. Comorbid Occurrence of Eosinophilic Esophagitis and Inflammatory Bowel Disease

Using the Inform Diagnostics database, which is a national electronic repository of histopathologic records from patients distributed throughout the entire United States, the authors performed a case-control study among 302,061 patients undergoing bidirectional endoscopy on the same day.

The database contained 3860 ulcerative colitis (UC) patients, 3330 Crohn’s disease (CD) patients, 1476 patients with indeterminate colitis with respect to UC or CD, and 5296 MC (microscopic colitis) patients. 

Key findings:

  •  EoE was less common in the overall IBD, CD, and MC case populations than the control population. Adjusted odds ratios (compared to control) :
    • EoE and IBD aOR 0.64
  • EoE and Crohn’s aOR 0.41
  • EoE and UC aOR 0.97
  • EoE and Indeterminate Colitis aOR 0.29
  • EoE and MC aOR 0.68

My take: (partly from authors) “Unexpectedly, the present analysis revealed statistically significant inverse relationships between EoE and CD or MC, but not UC.” Because endoscopy is often undertaken in those with a suspicion of IBD, EoE can be identified in the IBD population surreptiously; however, its frequency is likely less than in the general population.

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  1. Pingback: Genetic Basis of Eosinophilic Esophagitis | gutsandgrowth

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