Food-induced Immediate Response of the Esophagus - a newly identified Syndrome in Patients with Eosinophilic Esophagitis.

Biedermann, Luc; Holbreich, Mark; Atkins, Dan; Chehade, Mirna; Dellon, Evan S; Furuta, Glenn T; Hirano, Ikuo; Gonsalves, Nirmala; Greuter, Thomas; Katzka, David A; De Rooij, Willemijn; Safroneeva, Ekaterina; Schoepfer, Alain; Schreiner, Philipp; Simon, Dagmar; Simon, Hans Uwe; Warners, Marijn; Bredenoord, Albert-Jan; Straumann, Alex (2021). Food-induced Immediate Response of the Esophagus - a newly identified Syndrome in Patients with Eosinophilic Esophagitis. Allergy, 76(1), pp. 339-347. Wiley-Blackwell 10.1111/all.14495

[img] Text
Biedermann Allergy 2020_AAM.pdf - Accepted Version
Restricted to registered users only until 15 July 2021.
Available under License Publisher holds Copyright.

Download (1MB) | Request a copy
[img] Text
Biedermann_Allergy_2021.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (1MB) | Request a copy

BACKGROUND

Dysphagia is the main symptom of adult EoE. We describe a novel syndrome, referred to as "Food-induced Immediate Response of the Esophagus" (FIRE), observed in EoE patients.

METHODS

FIRE is an unpleasant/painful sensation, unrelated to dysphagia, occurring immediately after esophageal contact with specific foods. EoE experts were surveyed to estimate the prevalence of FIRE, characterize symptoms and identify food triggers. We also surveyed a large group of EoE patients enrolled in the Swiss EoE Cohort Study (SEECS) for FIRE RESULTS: Response rates were 82% (47/57) for the expert- and 65% (239/368) for the patient-survey, respectively. Almost 90% of EoE experts had observed the FIRE symptom-complex in their patients. Forty percent of EoE patients reported experiencing FIRE, more commonly in patients who developed EoE symptoms at a younger age (mean age of 46.4 vs. 54.1 years without FIRE; p<0.01) and in those with high allergic comorbidity. FIRE symptoms included narrowing, burning, choking and pressure in the esophagus appearing within 5 minutes of ingesting a provoking food that lasted less than 2 hours. Symptom severity rated a median 7 points on a visual analogue scale from 1-10. Fresh fruits/vegetables and wine were the most frequent triggers. Endoscopic food removal was significantly more commonly reported in male patients with vs. without FIRE (44.3% vs. 27.6%; p = 0.03).

CONCLUSIONS

FIRE is a novel syndrome frequently reported in EoE patients, characterized by an intense, unpleasant/painful sensation occurring rapidly and reproducibly in 40% of surveyed EoE patients after esophageal contact with specific foods.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Dermatology
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Pharmacology
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Safroneeva, Ekaterina; Simon, Dagmar and Simon, Hans-Uwe

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0105-4538

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

22 Jul 2020 21:05

Last Modified:

19 Feb 2021 17:39

Publisher DOI:

10.1111/all.14495

PubMed ID:

32662110

Uncontrolled Keywords:

Clinical Symptoms Eosinophilic Esophagitis (EoE) Eosinophilic Oesophagitis Food Allergy Food-induced immediate response of the Esophagus (FIRE) Immediate Response Oral Allergy Syndrome

BORIS DOI:

10.7892/boris.145301

URI:

https://boris.unibe.ch/id/eprint/145301

Actions (login required)

Edit item Edit item
Provide Feedback