Patients presenting at A&E with a Food Bolus Obstruction should be referred to a Gastroenterologist and not an ENT Specialist
Eosinophilic esophagitis: an underdiagnosed cause of dysphagia and food impaction to be recognized by otolaryngologists C. Górriz Gil · V.Matallana Royo2 · Ó. ÁlvarezMontero · A. Rodríguez Valiente et al HNO 2018, Volume 66, Issue 7, pp 534–542
The article includes details on epidemiology, pathophysiology clinical presentation and treatment of EoE with the following key points:
- EoE is the most common cause of dysphagia and food bolus impaction in children and young adults. It is the second cause of esophagitis after GORD
- EoE represents the final fibrotic state of many cases of oesophageal stenosis treated traditionally by ENT specialists with oesophageal dilation that could have been avoided with a correct diagnosis and prompt treatment
- Delayed diagnosis increases the chance of oesophageal strictures
- Undiagnosed EoE may present early to the ENT department with refractory aerodigestive symptomatology: aspiration, stridor and chronic cough
- Transnasal esophagoscopy (TNE), performed in-office by the otolaryngologist, is a safe and cost-effective procedure that can rule out and/or follow-up EoE, avoiding dependency and overload on the gastroenterology endoscopy departments
- PLRD-/GORD-like symptoms and other airway disorders can be the first signs of EoE; the ENT specialist should be aware of this
- EoE and GORD are distinct entities, but frequently co-exist and interact bidirectionally
EoE is associated with other comorbid allergic conditions in up to 80% of cases
Untreated, EoE can lead to oesophageal stricture and functional abnormalities
To read the article click here