Prevalence of eosinophilic esophagitis in refractory gastroesophageal reflux disease in Egyptian patients

Abstract Background Gastroesophageal reflux disease (GERD) is a prevalent gastrointestinal disorder characterized by diverse symptoms and lesions impacting the esophagus and adjacent regions, resulting from the backward flow of stomach contents into the esophagus. Eosinophilic esophagitis (EoE) has become a significant alternative diagnosis for persons with persistent GERD symptoms. This study aims to assess the prevalence of EoE in Egyptian patients who inadequately react to GERD treatments. Methods Esophageal tissue samples were collected from all patients exhibiting persistent GERD symptoms. EoE was identified based on esophageal mucosal biopsies showing at least 15 eosinophils per high-power field (HPF) and symptoms suggestive of esophageal dysfunction, following the exclusion of other causes of eosinophilia. Results Thirty hundred patients with persistent GERD symptoms were included in this study. These patients were divided into two groups: those diagnosed with EoE (n = 12) and those without this condition (n = 288). Dysphagia (p = 0.012), occult blood in stool (p = 0.024) and H. pylori antigen (p = 0.013) were significantly in favour of patients with eosinophilic oesophagitis and these factors were predictors of eosinophilic oesophagitis (p < 0.05). Conclusion The prevalence of eosinophilic esophagitis (EoE) among Egyptian patients with refractory GERD was found to be 4%, indicating that EoE is relatively uncommon type of esophagitis. EoE showed a notable association with dysphagia, occult blood in stool and Hpylori infection which are considered predictors of this type of esophagitis.