Study on the association between eosinophilic esophagitis and bronchial asthma in Egyptian patients with esophageal symptoms

Introduction Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus in which eosinophils play a major role in its pathogenesis and is presented clinically by esophageal dysfunction. EoE represents the second most common cause of chronic esophageal disease after gastroesophageal reflux disease (GERD) and is considered the most common cause of dysphagia in both adults and children. Asthma is a well-known chronic inflammatory disorder of the airways that involves several inflammatory cells including eosinophils. Multiple inflammatory mediators developed the characteristic pathophysiological changes that resulted in airway obstruction and appearance of symptoms of cough and breathlessness. This study aimed to study the incidence of EoE in Egyptian patients with bronchial asthma and address the patient’s characters and risk factors that increases the association. Settings and design This study was carried out on Egyptian asthmatic patients with esophageal symptoms. From 200 asthmatic patients, only 89 patients had esophageal symptoms (heartburn, regurgitation, or dysphagia) and were prepared for endoscopy. Patients and methods Upper gastrointestinal tract endoscopy was performed on all 89 cases and the findings were reported. Esophageal biopsy was taken from all cases and examined histopathologically for EoE criteria. Results The results showed that about 11% of asthmatic patients who suffered from GERD symptoms had associated EoE confirmed by esophageal biopsy and histologic findings. The incidence of EoE was increased in atopic asthmatic patients who had high immunoglobulin E. Conclusion Asthmatic patients who suffered from GERD symptoms should be assessed for EoE by endoscopic and histopathological examination.