Prevalence of Eosinophilic Esophagitis in Patients With Gastroesophageal Reflux Symptoms

Eosinophilic esophagitis (EoE) is a chronic, immune- or antigen-mediated inflammatory condition of the esophagus, which is characterized by eosinophil-predominant infiltration and resulting esophageal dysfunction. In adults, it typically presents with dysphagia and food impaction. In children, common symptoms include vomiting, feeding difficulties, and abdominal pain. Diagnosis is established in symptomatic individuals by esophagogastroduodenoscopy with esophageal biopsy, demonstrating at least 15 eosinophils per high-power field (HPF) in the esophageal mucosa. Despite increasing recognition of EoE globally, data from low- and middle-income countries (LMICs), including Nepal, remain scarce.

This study was conducted to find the prevalence of EoE in patients with symptoms of gastroesophageal reflux (GER) in Nepal.

A cross-sectional study was carried out at the tertiary care level central hospital in Nepal from January 2024 to August 2024, among a total of 60 participants with symptoms of GER. All participants underwent an esophagogastroduodenoscopy (EGD), and esophageal biopsies were taken to check for the presence of eosinophilic esophagitis (EoE). Data on demographic and clinical characteristics, endoscopic findings, peripheral blood absolute eosinophil count, and history of proton pump inhibitors (PPI) use were obtained. Statistical analysis was done using IBM SPSS Statistics for Windows, version 21 (IBM Corp., Armonk, NY, USA).

EoE was identified in four patients (6.67%) based on histopathological examination of esophageal biopsy samples with no gender predilection and was found predominantly in participants aged 40 or more. The findings suggest the consideration of EoE as a diagnostic possibility in patients with GER symptoms in Nepal.