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Gastrointest. Disord. 2018, 1(1), 3-14; https://doi.org/10.3390/gidisord1010002

Intrabolus Pressure Has Better Correlation Than Eosinophilia with Dysphagia Severity in Fibrostenotic Eosinophilic Esophagitis: A Pilot Study

1
Division of Digestive Diseases and Nutrition, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
2
Department of Evidence Based Medicine and Outcomes Research, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
3
Joy McCann Culverhouse Center for Swallowing Disorders, Division of Digestive Diseases and Nutrition, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
*
Author to whom correspondence should be addressed.
Received: 13 July 2018 / Revised: 2 August 2018 / Accepted: 9 August 2018 / Published: 13 August 2018
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Abstract

Eosinophilic esophagitis is characterized by dysphagia with esophageal eosinophilia. We sought to determine if intrabolus pressure measurements on high-resolution manometry had any correlation with dysphagia improvement following standard therapy for patients with fibrostenotic eosinophilic esophagitis. Consecutive patients were prospectively enrolled at our swallowing center. Dysphagia scores, esophageal eosinophil counts, endoscopic reference scores, and intrabolus pressure measurements were compared at baseline and following therapy with 8 weeks of a proton-pump inhibitor and serial bougie dilation to a luminal diameter of 17 mm. Five patients were included in the study. The median age was 38 years. The average endoscopic reference score improved from 5.0 to 2.4 (p = 0.007). The mean esophageal diameter improved from 10.8 mm to 17.2 mm (p = 0.001). Dysphagia severity scores improved from a mean value of 34.2 to 10.8 (p = 0.004). Mucosal eosinophilia had no correlation with dysphagia severity. Mean intrabolus pressure improved from 21.8 mmHg to 11 mmHg (p = 0.001). There was strong correlation between a decrease in intrabolus pressure and improvement in dysphagia severity; however, this was not significant (p = 0.108). Intrabolus pressure has strong correlation with dysphagia severity following therapy for fibrostenotic eosinophilic esophagitis. Bougie dilation provides improvement in dysphagia despite persistent mucosal eosinophilia. View Full-Text
Keywords: eosinophilic esophagitis; esophageal dilation; high-resolution manometry; dysphagia; endoscopy eosinophilic esophagitis; esophageal dilation; high-resolution manometry; dysphagia; endoscopy
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Colizzo, J.; Clayton, S.; Kumar, A.; Richter, J. Intrabolus Pressure Has Better Correlation Than Eosinophilia with Dysphagia Severity in Fibrostenotic Eosinophilic Esophagitis: A Pilot Study. Gastrointest. Disord. 2018, 1, 3-14.

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