Refractory GERD can represent an initial stage of eosinophilic esophagitis

This study included patients with refractory gastroesophageal reflux disease (GERD) after using at least 40 mg of a proton pump inhibitor (PPI). They were placed on a restriction diet based on the results of skin prick testing and atopy patch testing with foods.

The prevalence of sensitization to foods was 28%. Asthmatic patients showed higher sensitization to foods.

Eosinophils were present in the esophageal mucosa in 16% of patients, and this correlated with greater sensitization to foods. One case of eosinophilic esophagitis was confirmed.

A diet excluding sensitizing foods led to clinical improvement regarding GERD symptoms.

The presence of eosinophils in esophageal mucosa associated with greater sensitization to foods and the response to a restriction diet in patients with positive test results suggest that refractory GERD can represent an initial stage of eosinophilic esophagitis.

References:

Sensitization to foods in gastroesophageal reflux disease and its relation to eosinophils in the esophagus: is it of clinical importance? Ann Allergy Asthma Immunol. 2010 Nov;105(5):359-63. Pomiecinski F, Yang AC, Navarro-Rodrigues T, Kalil J, Castro FF.
Image source: Eosinophilic esophagitis, Wikipedia, GNU Free Documentation License.