Changes in Esophageal Distensibility with Proton Pump Inhibitors in Patients with Esophageal Eosinophilia: A Pilot Study
Studying Esophagus Stiffness in Certain Patients
John Wo, MD
Primary Investigator
Brief description of study
The purpose of this study is to measure the stiffness of the esophagus before and after treatment for inflammation in the esophagus.
Detailed description of study
Participants who qualify and are undergoing endoscopy will complete a short survey before their endoscopy, and agree to have the stiffness of their esophagus measured to see whether they could be at risk for esophageal impactions.
- Diagnostic TestDiagnostic test Endoflip - Resolution of esophageal eosinophilia by a 2-month course of high dose PPI in patients will lead to improvement in esophageal distensibility, and thus should produce improvement in dysphagia symptoms.
Eligibility of study
You may be eligible for this study if you meet the following criteria:
- Conditions: Esophageal Eosinophilia
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Age: 18 years - 65 years
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Gender: All
Inclusion Criteria:
1. Diagnosis of Eosinophilic Esophagitis, as defined by a peak count of > 15 eosinophils per high power field (HPF) on light microscopy based on esophageal biopsies.
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Exclusion Criteria:
1. Patients whose elevated eosinophil count on esophageal biopsies are thought to be due to another condition such as eosinophilic GI diseases, GERD, celiac disease, Crohn’s disease, esophageal infection, hypereosinophilic syndrome, drug hypersensitivity, vasculitis, pemphigus, connective tissue diseases, graft vs. host disease
2. Age 65 years
3. Contraindication for biopsy, such as presence of esophageal varices, coagulopathy
4. History of esophageal surgery, gastric or esophageal malignancy, anatomical abnormality, or major primary motility disorder (such as achalasia)
5. History of esophageal perforation
6. History of esophageal stent placement
7. Pregnancy
8. Prisoners
This study investigates how the stiffness of the esophagus changes in patients with esophageal eosinophilia when treated with proton pump inhibitors (PPIs). Esophageal eosinophilia is a condition where there are too many eosinophils, a type of white blood cell, in the esophagus, which can cause inflammation. The purpose of this study is to see if reducing this inflammation with PPIs can make the esophagus less stiff and improve swallowing difficulties.
Participants will undergo a diagnostic test called Endoflip, which measures the stiffness of the esophagus. Before their endoscopy, participants will complete a short survey. The study will observe if a 2-month course of high-dose PPIs improves esophageal distensibility and symptoms of dysphagia, which is difficulty swallowing.
- Who can participate: Participants must have a diagnosis of Eosinophilic Esophagitis with more than 15 eosinophils per high power field in esophageal biopsies and be under 65 years old. They should not have other conditions like GERD or Crohn’s disease that could affect eosinophil counts.
- Study details: Participants will have their esophagus stiffness measured using a test called Endoflip and take a high-dose PPI for two months. Their esophageal distensibility will be measured again to check for improvement.
