Background and Aims: Two distinct e ndoscopic phenotypes
of E osinophilic Esophagitis (EoE) h ave been identified: t he
inflammatory (IP) a nd the stenosing (SP) p henotype. I t is not
known whether these EoE-associated phenotypes are reflective
of different phases during disease course. We aimed to assess
the phenotype a t initial EoE p resentation and d iagnosis and to
evaluate if SP increases over time.
Methods: R etrospective a nalysis of t he Swiss EoE Database
(SEED) extended b y a review of p atients charts, endoscopy
and pathology records.
Results: F orty-four E oE p atients were a nalyzed (33 males,
mean age at index visit 41 ± 14 years, all Caucasians). Median
follow-up t ime was 3.1 years (IQR 1-4, r ange 1 -18 years).
Median diagnostic delay w as 5 y ears (IQR 2-16, range 0-34
years). A t first diagnosis, 3 2% ( 14/44) o f EoE patients h ad
already presented w ith a stenosis. T he mean d iameter o f the
stenoses w as 1 0 ± 2 mm, and the mean length was 2 .8 ± 2 .9
cm. Peak e osinophil count d id n ot c hange over t ime (48 ± 39
eos/HPF at index visit vs. 59 ± 41 eos/HPF at end of follow-up,
n=44). The risk of the presence of a stenosis at index visit was
0% f or a d isease duration of 0 -4 y ears, 37% f or a d isease
duration between 5-10 years and 67% f or a d isease duration
>10 years (p = 0.0035, trend test).
Conclusions: T he frequency of e sophageal stenoses i s
proportional to the disease duration, whereas the inflammatory
activity does n ot s ignificantly c hange over t ime. O ur f indings
underscore the necessity to reduce diagnostic delay in EoE and
to control the underlying inflammatory processes to prevent
esophageal remodeling.