A recently-published study in Clinical Gastroenterology and Hepatology has shown an FDA-approved gastrointestinal device can help to clarify the level of early oesophageal scarring in paediatric eosinophilic oesophagitis (EoE).

Researchers found that oesophageal distensibility, determined by the EndoFLIP device, is a measure of fibrostenotic severity (scarring). 

Currently, the extent of fibrosis can only be evaluated visually during endoscopy. With symptoms being highly variable, it can go unnoticed or be inaccurately reported.

Hopefully, the findings of this study could point towards a means of earlier identification of scarring caused by EoE and quicker, more targeted intervention.

Methods

The study analysed 59 prospectively-recruited patients aged 9-21 who were undergoing endoscopy for suspected or previously-diagnosed EoE.

Oesophageal distensibility was evaluated by the distensibility index (DI), and receiver operating characteristic analysis was performed to determine the utility of distensibility in defining esophageal rigidity in paediatric EoE.

Results

DI (mm²/mmHg) was significantly lower in patients with fibrotic as compared with inflammatory features on endoscopy vs median (P=0.02) and showed no correlation with eosinophil count.

Researchers proposed that a DI<4.5 mm²/mmHg predicted grade 2 rings on endoscopy with area under the curve of 0.81 (P=0.0004). DI predicted food impaction in both unadjusted and adjusted models (P=0.0486).

Links

• 'Esophageal Distensibility Defines Fibrostenotic Severity in Pediatric Eosinophilic Esophagitis' - Clinical Gastroenterology and Hepatology