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Updated: Aug 15, 2025

Author Spotlight: Investigating the Pathophysiology of Eosinophilic Esophagitis
Published on: May 10, 2024
The Slender Esophagus: Unrecognized Esophageal Narrowing in Eosinophilic Esophagitis
Kristle L Lynch1, Alain J Benitez2, Bridget Godwin2
1Division of Gastroenterology and Hepatology, The University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Introduction:
Inflammation in eosinophilic esophagitis (EoE) often leads to esophageal strictures. Evaluating esophageal narrowing is clinically challenging. We evaluated esophageal distensibility as related to disease activity, fibrosis, and dysphagia.
Methods:
Adult patients with and without EoE underwent endoscopy and distensibility measurements. Histology, distensibility, and symptoms were analyzed.
Results:
Patients with EoE had significantly lower distensibilities than controls. We found a cohort with esophageal diameter under 15 mm despite lack of dysphagia.
Discussion:
This study raises concern that current assessments of fibrostenosis are suboptimal. We describe a cohort with unrecognized slender esophagus that were identified through impedance planimetry measurements. This tool provides additional information beyond symptomatic, histologic, and endoscopic assessments.
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