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TOPLINE:

In the US, veterans with atopic diseases were more likely to develop eosinophilic esophagitis (EoE) than those without, with food allergies showing the strongest association.

METHODOLOGY:

• Researchers conducted a cross-sectional study to assess the prevalence and odds of EoE across patients with various atopic diseases and examine associated demographic characteristics and risk factors.
• They analyzed the data of 1,110,189 patients (89.6% men; 81.3% White individuals) sourced from the US Veterans Health Administration database from 2009 to 2021.
• The researchers collected patient data on atopic diseases such as asthma, eczema, allergic rhinitis, and food allergies.

TAKEAWAY:

• Overall, 26% (288,193) had at least one atopic disease, and 0.092% (1022) had an EoE diagnosis.
• Among patients with atopic diseases, those with milk allergy had the highest odds of developing EoE (odds ratio [OR], 49.43; 95% CI, 24.28-100.66), followed by those with egg allergy (OR, 11.65; 95% CI, 4.81-28.17) and wheat allergy (OR, 9.46; 95% CI, 5.21-17.18). By contrast, patients with asthma (OR, 3.12; 95% CI, 2.60-3.76) or rhinitis (OR, 3.09; 95% CI, 2.71-3.53) had lower odds.
• Men with allergies (OR, 2.87; 95% CI, 2.52-3.27) and women with allergies (OR, 3.29; 95% CI, 2.53-4.21) had higher odds of developing EoE than men without allergies.
• Milk allergy was the strongest predictor of EoE (adjusted OR, 19.9; 95% CI, 8.39-40.63).

IN PRACTICE:

“Providers should have a high clinical suspicion for EoE if a patient has GI [gastrointestinal] symptoms with history of atopic disease and especially milk, wheat, or egg allergy,” the authors wrote. “Consideration should be given to screening all patients with atopic disease for upper GI symptoms, and early diagnosis of EoE is crucial to improved treatment outcomes,” they added.

SOURCE:

Michael Tadros, MD, with the Albany Medical Center, Albany, New York, was the corresponding author of the study, which was published online on August 22 in International Archives of Allergy and Immunology.

LIMITATIONS:

Reliance on International Classification of Diseases codes for patient identification and focus on a selected veteran population with a 9:1 men-to-women ratio may limit generalizability. 

DISCLOSURES:

This study was supported using resources and facilities at the US Department of Veterans Affairs (VA) Informatics and Computing Infrastructure. Support for VA Content Management System data was provided through the VA Health Services Research and Development Service and VA Information Resource Center. Christopher Ashley and Darren E. Gemoets declared being employees of the VA.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.