ALCOHOL INDUCED GASTROINTESTINAL SYMPTOMS IN EOSINOPHILIC ESOPHAGITIS

Abstract

Introduction Eosinophilic esophagitis is a recognized cause of gastrointestinal symptoms including food impaction, dysphagia, and heartburn. In eosinophilic airway diseases, alcohol ingestion can trigger allergic symptoms, and many EoE patients are intolerant of alcohol. Methods 548 patients with Eosinophilic Esophagitis (EoE) ICD9/10 codes from 2011-2016 were sent a 27-question survey that identified patients with EoE, gastroesophageal reflux disease (GERD) or neither, and inquired about alcohol ingestion correlation with the following symptoms: abdominal pain, chest pain, coughing, nausea, substernal burning, choking, food impaction and regurgitation. 88/548 patients completed the surveys, and another 82 surveys were administered personally to patients in Scripps Internal Medicine and Gastroenterology clinics. Results 47 patients were identified as likely having GERD, 84 as EoE, and 39 as neither (controls). For controls, 30.7% of patients reported adverse symptoms with alcohol ingestion, while 54.7% and 70.2% of EoE and GERD patients, respectfully, reported symptoms (OR 2.72 for EoE group vs. controls, P-value 0.015). The average number of symptoms for controls was 1.33, 1.17 for GERD (p-value 0.315), and 2.32 for EoE (p-value: 0.002). For EoE patients, only a few sips of alcohol were reported to provoke symptoms in approximately 20% of patients vs. 0 of controls or GERD patients. Conclusions Patients with EoE were found to be more likely than controls but less likely than GERD patients to report adverse gastrointestinal symptoms associated with alcohol ingestion. When present, EoE patients report a greater number of symptoms than GERD and control patients and were more easily provoked by minimal amounts of alcohol.