S0710 Epidemiology of Eosinophilic Esophagitis in Inflammatory Bowel Disease and General Population: A Population-Based Study

Abstract

INTRODUCTION: Some chronic immune-mediated diseases like Eosinophilic esophagitis (EoE) and inflammatory bowel disease (IBD) have similar pathogenesis. Recent studies have shown that both the prevalence and incidence of EoE and IBD are rising in developed countries. However, only few case reports on concurrent EoE and IBD were published and only limited data is available describing the epidemiology. Our objective was to evaluate the prevalence and associated comorbidities of concurrent EoE and IBD. METHODS: We performed a population-based study using IBM EXPLORYS, a HIPPA-enabled web platform that includes over 65 million patient data, pooled from multiple healthcare systems with distinct electronic health records. The prevalence of EoE in patients with IBD and in general population without IBD was compared. The IBD patient group was further stratified into Crohn's disease and Ulcerative colitis groups. Prevalence was calculated per 100,000 patients. Patient characteristics like age, gender and co-morbid immune-mediated disorders like celiac disease, asthma, and eczema were compared between patients with and without EoE in Crohn's disease, UC and the general population. Data were analyzed with R statistical software (RStudio, Inc. Boston, MA). RESULTS: A total of 197,050 patients with IBD and 64,095,520 without IBD were identified. Among the 197,050 cohorts with IBD, 100,780 (51%) had CD and 96,270 (49%) had UC. EoE prevalence is significantly higher in the IBD group compared to the general population (533 vs. 47, P < 0.0001). There was a significant difference in the prevalence of EoE between Crohn's disease and UC group (575 vs. 488, P = 0.008). The proportion of patients between age 18–65 years was significantly higher in EoE all 3 groups. A significant association of asthma and eczema with EoE was noted in all three groups. CONCLUSION: The risk of EoE is significantly higher among IBD patients, both Crohn's disease and UC. Concurrent diagnoses of EoE and IBD might modify the risk of IBD- and EoE-related complications. Studies to evaluate the mechanisms underlying the observation are needed.Table 1.: Prevalence and characteristics of patients with Eosinophilic esophagitis (EoE) associated with Crohn's disease, Ulcerative colitis and in general population