Background and Aims: Eosinophilic Esophagitis (EoE) is
reported with increasing frequency over the last two decades.
However, it is still unknown whether this reflects a true increase
in incidence or just an increased awareness by
gastroenterologists. Therefore, we evaluated the incidence and
cumulative prevalence of EoE in Olten county over the last 20
years.
Methods: Olten county is an area of approximately
91,000 inhabitants without pronounced demographic changes in
the last two decades. EoE evaluation is based upon two
gastroenterology centers and one pathology center. No public
programs for increased EoE awareness were implemented in
this region. All EoE patients diagnosed from 1989 to 2009 were
entered prospectively into the Olten county database.
Results: Fourty-six patients (76% males, mean age 41±16 yrs)
were diagnosed with EoE from 1989 to 2009. Ninety-four
percent presented with dysphagia. In 70% of the patients
concomitant allergies were found. The number of upper
endoscopies per year was stable during the entire observation
period. An average annual incidence rate of 2/100,000 was
found (range 0-8) with a marked increase in the period from
2001 to 2009. A current cumulative EoE prevalence of
43/100,000 inhabitants was calculated. The mean diagnostic
delay (time from first symptoms to diagnosis) was 4.3 years
from 1989 to 1998 and 4.8 years from 1999 to 2009.
Conclusions: Over the last 20 years, a significant increase in
EoE incidence was found in a stable indicator region of
Switzerland. The constant rate of upper endoscopies, the
constant diagnostic delay, as well as the lack of EoE awareness
programs in Olten county indicate a true increase in EoE
incidence.