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.


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.

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