P2808 - Prevalence of Eosinophilic Esophagitis in Inflammatory Bowel Disease Patients

William Bigelow, MD¹, Emily McGowan, MD, PhD², Bryan G. Sauer, MD, MSc, FACG¹, Anne Tuskey, MD, FACG¹
1University of Virginia, Charlottesville, VA; 2Division of Allergy and Immunology, University of Virginia, Charlottesville, VA

Introduction: While recent studies have suggested an increased prevalence of eosinophilic esophagitis (EoE) among patients with inflammatory bowel disease (IBD), these studies have been retrospective in nature. Furthermore, these studies have primarily used administrative coding, which has a low sensitivity for diagnosing EoE. In the adult population, dysphagia is the most common symptom of EoE. The aim of this pilot study was to prospectively assess the prevalence of dysphagia symptoms among IBD patients seen in the outpatient gastroenterology clinic at a single academic center.

Methods: Consecutive IBD patients were administered a questionnaire, which included the validated Brief Esophageal Dysphagia Questionnaire (BEDQ) as well as standardized questions assessing IBD subtype, medications, and comorbid allergic conditions (asthma, seasonal allergies, eczema, food allergies, and eosinophilic esophagitis). Demographic information was collected on chart review. A positive response to symptoms within the past 14 days was defined as an answer of “rarely,” “sometimes,” “often,” or “always.” Patients indicating a score of 3 or greater on any BEDQ question were offered an esophagogastroduodenoscopy (EGD) as appropriate clinical management to assess for etiologies of dysphagia, including EoE.

Results: In total, 123 surveys were completed, and 3 patients had a prior history of EoE (2.4%). Among the remaining 120 subjects (mean age was 40; 60% female, 88.2% Non-Hispanic White; 67.5% Crohn's disease; 32.5% Ulcerative Colitis), 21.6% (n=26) of patients screened positive for clinically significant dysphagia and were offered an EGD for further evaluation. The highest reported dysphagia symptoms were food feeling stuck in the chest (30%), food stuck in the throat (34%), and pill dysphagia (30.8%). While the prevalence of dysphagia was higher among women (65.2% v. 34.8% for males), in patients with Crohn's disease (71.7 v. 28.3% for UC), and among patients with other allergic conditions (56.5% v. 43.5% for non-atopic), these did not meet statistical significance.

Discussion: This study demonstrates a high prevalence of dysphagia symptoms in the IBD population. Given these findings, assessment of dysphagia should be addressed by clinicians for IBD patients and further evaluated with an EGD when appropriate. Further investigation with endoscopic evaluation and histology review are planned as follow-up of these results to assess for the prevalence of eosinophilic esophagitis in this patient population.

Disclosures:
William Bigelow indicated no relevant financial relationships.
Emily McGowan: AstraZeneca – Advisory Committee/Board Member, Consultant. Bristol Myers Squibb – Advisory Committee/Board Member, Consultant. Regeneron Pharmaceuticals Inc./Sanofi – Advisory Committee/Board Member, Consultant. Takeda Pharmaceuticals – Advisory Committee/Board Member, Consultant.
Bryan Sauer: Regeneron – Consultant, Speakers Bureau. Sanofi – Consultant, Speakers Bureau. Takeda – Consultant, Speakers Bureau.
Anne Tuskey indicated no relevant financial relationships.

William Bigelow, MD¹, Emily McGowan, MD, PhD², Bryan G. Sauer, MD, MSc, FACG¹, Anne Tuskey, MD, FACG¹. P2808 - Prevalence of Eosinophilic Esophagitis in Inflammatory Bowel Disease Patients, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.