TY - JOUR
T1 - Food-induced immediate response of the esophagus—A newly identified syndrome in patients with eosinophilic esophagitis
AU - Biedermann, Luc
AU - Holbreich, Mark
AU - Atkins, Dan
AU - Chehade, Mirna
AU - Dellon, Evan S.
AU - Furuta, Glenn T.
AU - Hirano, Ikuo
AU - Gonsalves, Nirmala
AU - Greuter, Thomas
AU - Gupta, Sandeep
AU - Katzka, David A.
AU - de Rooij, Willemijn
AU - Safroneeva, Ekaterina
AU - Schoepfer, Alain
AU - Schreiner, Philipp
AU - Simon, Dagmar
AU - Simon, Hans Uwe
AU - Warners, Marijn
AU - Bredenoord, Albert-Jan
AU - Straumann, Alex
N1 - Funding Information:
Dr Biedermann reports personal fees from Dr Falk Pharma, personal fees from Vifor AG Switzerland, personal fees from Esocap AG, personal fees from Sanofi‐Aventis AG, personal fees from Calypso Biotech AG outside the submitted work. Dr Holbreich, Dr Atkins, Dr Dellon, Dr de Rooij, Dr Safroneeva, Dr Schoepfer, Dr D. Simon, Dr HU Simon, Dr Warners and Dr Straumann have nothing to disclose. Dr Chehade reports grants from NIH (R01‐AI140133, U54‐AI117804), grants from PCORI, grants from APFED/AAAAI, grants and personal fees from Regeneron, grants and personal fees from Shire, grants and personal fees from Allakos, personal fees from Adare, personal fees from Nutricia, personal fees from Medscape, personal fees from Annenberg Center for Health Sciences, outside the submitted work. Dr Furuta reports other from EnteroTrack, grants from Holoclara, grants from National Institutes of Health, other from Shire/Takeda, outside the submitted work. Dr Hirano reports personal fees and other from Shire/Takeda, personal fees and other from Regeneron/Sanofi, personal fees and other from Adare, personal fees and other from Allakos, personal fees and other from Receptos/Celgene, personal fees and other from AstraZeneca, personal fees from Gossamer, personal fees from Arena, personal fees from Esocap, personal fees from Lilly, outside the submitted work. Dr Gonsalves reports personal fees from Allakos Inc, personal fees from Up To Date, outside the submitted work. Dr Greuter reports grants from Novartis Research Foundation, personal fees from Falk Pharma, grants from Vifor, outside the submitted work. Dr Katzka reports grants from Shire, outside the submitted work. Dr Schreiner reports personal fees from Pfizer, personal fees from Takeda, personal fees from Janssen‐Cilag, outside the submitted work. Dr Bredenoord reports grants from Nutricia, grants from Norgine, grants from SST, grants from Bayer, personal fees from Laborie, personal fees from Arena, personal fees from Esocap, personal fees from Medtronic, personal fees from Dr Falk Pharma, personal fees from Calypso, personal fees from Reckett Benkiser, personal fees from Regeneron, personal fees from AstraZeneca, other from SST, outside the submitted work.
Publisher Copyright:
© 2020 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/1
Y1 - 2021/1
N2 - Background: Dysphagia is the main symptom of adult eosinophilic esophagitis (EoE). We describe a novel syndrome, referred to as “food-induced immediate response of the esophagus” (FIRE), observed in EoE patients. Methods: Food-induced immediate response of the esophagus is an unpleasant/painful sensation, unrelated to dysphagia, occurring immediately after esophageal contact with specific foods. Eosinophilic esophagitis 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 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 years vs 54.1 years without FIRE; P <.01) and in those with high allergic comorbidity. Food-induced immediate response of the esophagus 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 to 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 =.03). Conclusions: Food-induced immediate response of the esophagus 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.
AB - Background: Dysphagia is the main symptom of adult eosinophilic esophagitis (EoE). We describe a novel syndrome, referred to as “food-induced immediate response of the esophagus” (FIRE), observed in EoE patients. Methods: Food-induced immediate response of the esophagus is an unpleasant/painful sensation, unrelated to dysphagia, occurring immediately after esophageal contact with specific foods. Eosinophilic esophagitis 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 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 years vs 54.1 years without FIRE; P <.01) and in those with high allergic comorbidity. Food-induced immediate response of the esophagus 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 to 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 =.03). Conclusions: Food-induced immediate response of the esophagus 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.
KW - clinical symptoms
KW - eosinophilic esophagitis (EoE)
KW - food-induced immediate response of the esophagus (FIRE)
KW - immediate response
KW - oral allergy syndrome
UR - https://www.scopus.com/pages/publications/85089496338
U2 - 10.1111/all.14495
DO - 10.1111/all.14495
M3 - Article
C2 - 32662110
SN - 0105-4538
VL - 76
SP - 339
EP - 347
JO - Allergy: European Journal of Allergy and Clinical Immunology
JF - Allergy: European Journal of Allergy and Clinical Immunology
IS - 1
ER -