Unveiling the Strength of Association of Various Allergies to Eosinophilic Esophagitis and Gastroenteritis: A Comprehensive Nationwide Analysis
American Journal of Gastroenterology
Introduction: Eosinophilic esophagitis (EoE) and eosinophilic gastroenteritis (EoG) manifest with diverse gastrointestinal symptoms, and studies have reported their coexistence in 75% of cases. Milk allergy is a known correlate of these conditions, and dietary modification through milk avoidance is considered a primary dietary modification. This study aims to assess the strength of association between various atopic comorbidities and allergies with EoE and EoG, utilizing the largest inpatient database available. Methods: In this retrospective study, we analyzed the National Inpatient Sample (NIS) database spanning 2016-2020. Adult hospitalizations with EoE or EoG were identified using ICD-10 codes. We applied a 1: 1 matching method and evaluated covariate balance (Figure 1). Categorical variables were assessed using the Chi-square test, while continuous variables were analyzed using Student’s t-test. Multivariate logistic regression models were developed, including variables with a P-value # 0.2 in univariate analysis and known confounders. Results: Among the 35,320 patients with EoE or EoG, we matched 6,092 patients with those without EoE or EoG. Patients with EoE or EoG exhibited significantly higher odds of experiencing esophageal food impaction, dysphagia, non-specific abdominal pain, celiac disease, atopic dermatitis, and allergic rhinitis. The strongest associations were found with milk allergy, peanut allergy, egg allergy, and bee sting allergy (Table 1). Conclusion: As evidenced here, there are many nutritional and environmental causes for EoE and EoG. Given the severity of the sequelae of these diseases, it would benefit clinicians to develop a systematic approach in eliminating triggers. Our study supports avoidance of foods in the decreasing order of the strength of association in patients not responding to milk avoidance only. This study can serve as a starting point for further research into the strength of association with other food allergies in order to facilitate discovery of the offending agent and to keep from impinging on the patient’s comfort when restricting food.
Dharmarpandi G, Rasheed W, Anil M, Ishfaque S, Qureshi SN, Anees M. Unveiling the strength of association of various allergies to eosinophilic esophagitis and gastroenteritis: a comprehensive nationwide analysis. Am J Gastroenterol. 2023 Oct;118(10S):S406-S407. doi:10.14309/01.ajg.0000951844.30775.fd