Recurrence of food bolus impaction of the oesophagus: a retrospective observational study

Most cases of oesophageal food bolus impactions (FB) are one-off events, but recurrence is recognised. The aims of this study are to establish the recurrence rate of food bolus impaction and to identify features associated with recurrence.

Clinical records of all FB cases were reviewed and the following information was recorded (patient identifier, age, gender, dates of admission, history of oesophageal pathologies). Results of investigations were also recorded (contrast swallow, endoscopies, oesophageal manometry and pH studies). Cases were coded according to the most common oesophageal pathologies.

99 patients fulfilled inclusion criteria and consisted of 65 males and 34 females. Recurrence was noted in 9 patients who did not demonstrate any significant difference compared with cases suffering a single episode of FB in terms of age (Median 61 years IQR 49-79 years, Mann-Whitney U test 374.5, p = 0.71) or gender (recurrences in 3/34 females and 6/65 males, Pearson chi-square test 0.004, p = 0.99). 86 patients had investigations performed. Logistic regression demonstrated that hiatus hernia was the only oesophageal pathology demonstrating statistical significance in its association with FB recurrence (odds ratio 4.77 95% CI 1.15-19.82, p = 0.032). All other variables (oesophageal pathologies, age and gender of patients) were not statistically significant (p > 0.35).

The rate of recurrence of FB in our study group was 9%. Hiatus hernia was the only oesophageal pathology associated with recurrence of FB. It is not possible to draw any conclusions regarding the role of hiatus hernia in the causation of recurrence of FB.