- Title
- The outcome of patients with oesophageal eosinophilic infiltration after an eight-week trial of a proton pump inhibitor
- Creator
- Vazquez-Elizondo, G.; Ngamruengphong, S.; Khrisna, M.; DeVault, K. R.; Talley, N. J.; Achem, S. R.
- Relation
- Alimentary Pharmacology and Therapeutics Vol. 38, Issue 10, p. 1312-1319
- Publisher Link
- http://dx.doi.org/10.1111/apt.12513
- Publisher
- Wiley-Blackwell
- Resource Type
- journal article
- Date
- 2013
- Description
- Background: Current diagnostic guidelines recommend that eosinophilic oesophagitis (EoE) should be diagnosed only after GERD is excluded by a lack of response to a trial of acid suppression. There is limited information available providing outcome data about the effectiveness of this approach. Aim: To examine the impact of double-dose proton pump inhibitor (PPI) therapy on symptoms, endoscopic and histological features in patients with documented oesophageal eosinophilia consistent with EoE (≥15 eosinophils/high-power field). Methods: Sixty consecutive symptomatic patients with documented oesophageal eosinophilia received open-label omeprazole 20 mg orally twice daily before meals for 8 weeks. Clinical, endoscopic and histological (resolution: 0–5 eosinophils/HPF, partial improvement: 5–14 eosinophils/HPF), or no improvement: (≥15 eosinophils/HPF) evaluation was repeated at the end of this period. An expert GI pathologist, unaware of the study aims, reviewed all slides. Results: Clinical improvement occurred in 43 (71.6%), endoscopic signs were reduced in 34 (61.8%) and normalised in 12 (21.8%), and histologically, 34 (56.6%) improved, while 15 (25%) obtained complete resolution. Overall, 22 patients (36.7%) obtained both complete clinical and histological remission. Conclusions: More than 50% of patients with documented oesophageal eosinophilic infiltration in the EoE range improved when treated with a double-dose PPI trial for 8 weeks. These findings support the published guidelines recommending a PPI trial prior to diagnosing EoE, and confirm the existence of an eosinophilic oesophageal infiltrationPPI-responsive population.
- Subject
- eosinophilic oesophagitis; proton pump inhibitor; trial; GERD
- Identifier
- http://hdl.handle.net/1959.13/1340812
- Identifier
- uon:28581
- Identifier
- ISSN:0269-2813
- Language
- eng
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