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Esophageal Compliance Quantifies Epithelial Remodeling in Pediatric Patients With Eosinophilic Esophagitis
- Source :
- Journal of pediatric gastroenterology and nutrition, vol 68, iss 4
- Publication Year :
- 2019
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2019.
-
Abstract
- Author(s): Hassan, Maheen; Aceves, Seema; Dohil, Ranjan; Gharibans, Armen; Newbury, Robert; Proudfoot, James; Mousa, Hayat | Abstract: BackgroundThe management of eosinophilic esophagitis (EoE) relies on the severity of esophageal eosinophilia, yet there is poor evidence of its prediction of esophageal fibrotic remodeling and subsequent complications such as dysphagia, food impactions, or strictures. Functional luminal imaging planimetry (FLIP) has had limited use in pediatric patients to evaluate esophageal tissue mechanics. We aimed to standardize the FLIP technique and to measure esophageal compliance in children with EoE in comparison to controls.MethodsSubjects were enrolled into a prospective observational study and had FLIP performed at the time of endoscopy. We calculated esophageal distensibility and compliance for the total and segmental esophagus independently (ie, proximal, middle, and distal esophageal segments). We evaluated esophageal biopsies for eosinophilia and epithelial remodeling, calculated endoscopy scores, and documented patient symptoms.ResultsWe enrolled 11 EoE and 12 controls subjects, aged 5 to 18 years old. While EoE subjects had lower esophageal compliance (P = 0.004) than controls, the difference in distensibility did not reach significance (P = 0.151). Epithelial remodeling severity was more strongly correlated with compliance than with distensibility. Epithelial remodeling scores ≥2 had a significant association with lower compliance both segmentally and in the entire esophagus (P = 0.029), but not with distensibility. Compliance measures were more sensitive in detecting subjects with remodeling score ≥2 than distensibility (79% vs 64%).ConclusionsCompliance is a more sensitive measure of esophageal epithelial remodeling in children compared to distensibility, and a more appropriate measure of esophageal tissue mechanics. Standardized placement of the FLIP catheter is important to accurately assess esophageal compliance.
- Subjects :
- Male
dysphagia
functional luminal impedance planimetry
functional luminal imaging probe
esophageal mechanics
Medical and Health Sciences
Gastroenterology
eosinophilic esophagitis
0302 clinical medicine
Eosinophilia
Prospective Studies
Child
screening and diagnosis
medicine.diagnostic_test
Dysphagia
Esophageal Tissue
Detection
Catheter
medicine.anatomical_structure
motility
Child, Preschool
Female
030211 gastroenterology & hepatology
distensibility
medicine.symptom
4.2 Evaluation of markers and technologies
medicine.medical_specialty
pediatrics
Adolescent
Manometry
Food Allergies
compliance
impedance planimetry
Sensitivity and Specificity
Article
03 medical and health sciences
Esophagus
Clinical Research
030225 pediatrics
Internal medicine
medicine
Humans
Preschool
Eosinophilic esophagitis
Gastroenterology & Hepatology
business.industry
Eosinophilic Esophagitis
medicine.disease
Endoscopy
Compliance (physiology)
tissue remodeling
Case-Control Studies
Pediatrics, Perinatology and Child Health
Digestive Diseases
business
Subjects
Details
- ISSN :
- 15364801 and 02772116
- Volume :
- 68
- Database :
- OpenAIRE
- Journal :
- Journal of Pediatric Gastroenterology & Nutrition
- Accession number :
- edsair.doi.dedup.....2ec6c41b4a4e9fc26c58c28d45264498