{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T07:55:26Z","timestamp":1789545326818,"version":"build-2803163510"},"reference-count":33,"publisher":"Georg Thieme Verlag KG","issue":"09","funder":[{"DOI":"10.13039\/100009560","name":"American Gastroenterological Association","doi-asserted-by":"crossref","award":["Research Scholar Award"],"award-info":[{"award-number":["Research Scholar Award"]}],"id":[{"id":"10.13039\/100009560","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"crossref","award":["K24DK100548,R01DK101856,T32DK007634"],"award-info":[{"award-number":["K24DK100548,R01DK101856,T32DK007634"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background A proportion of patients with active eosinophilic esophagitis (EoE) have a normal-appearing esophagus on esophagogastroduodenoscopy (EGD). We aimed to determine the associations between the baseline clinical features and the endoscopically normal esophagus in EoE, as well as time trends in reporting.<\/jats:p>\n                  <jats:p>Methods In this retrospective study of active EoE cases from 2002\u200a\u2013\u200a2018, patients with and without esophageal endoscopic abnormalities were compared. Multivariable logistic regression identified the independent predictors of a normal EGD. The proportion of patients with a normal EGD was determined per year, and before and after the introduction of the first EoE guidelines and the EoE Endoscopic Reference Score (EREFS).<\/jats:p>\n                  <jats:p>Results Of 878 EoE patients, 101 (11.5\u200a%) had an endoscopically normal esophagus; they were younger (8.3 vs. 25.4 years), had shorter median symptom duration before diagnosis (2.8 vs. 5.0 years), were less likely to have dysphagia (40\u200a% vs. 76\u200a%) or food impaction (8\u200a% vs. 33\u200a%), and more likely to have abdominal pain (37\u200a% vs. 19\u200a%) (P\u200a&lt;\u200a0.01 for all). On multivariable logistic regression, independent predictors of a normal esophagus were younger age (odds ratio [OR] 0.96, 95\u200a% confidence interval [CI] 0.94\u200a\u2013\u200a0.98), abdominal pain (OR 2.03, 95\u200a%CI 1.13\u200a\u2013\u200a3.67), and lack of dysphagia (OR 0.49, 95\u200a%CI 0.26\u200a\u2013\u200a0.93). The proportion of patients with a normal esophagus decreased from 21\u200a% before the first EoE guidelines to 7\u200a% (P\u200a&lt;\u200a0.01) after introduction of the EREFS.<\/jats:p>\n                  <jats:p>Conclusions An endoscopically normal esophagus is seen in ~10\u200a% of active EoE patients and should not preclude biopsies; younger age, abdominal pain, and lack of dysphagia are independent predictors. The proportion of normal EGDs decreased over time, suggesting improved recognition of endoscopic findings.<\/jats:p>","DOI":"10.1055\/a-1284-5891","type":"journal-article","created":{"date-parts":[[2020,10,6]],"date-time":"2020-10-06T18:52:52Z","timestamp":1602010372000},"page":"886-892","source":"Crossref","is-referenced-by-count":21,"title":["Clinical features and time trends associated with an endoscopically normal esophagus in active eosinophilic esophagitis"],"prefix":"10.1055","volume":"53","author":[{"given":"Swathi","family":"Eluri","sequence":"additional","affiliation":[{"name":"Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA"},{"name":"Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Ryanne","family":"Corder","sequence":"additional","affiliation":[{"name":"University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Kim","sequence":"additional","affiliation":[{"name":"University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manaswita","family":"Tappata","sequence":"additional","affiliation":[{"name":"University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig C.","family":"Reed","sequence":"additional","affiliation":[{"name":"Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA"},{"name":"Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas J.","family":"Shaheen","sequence":"additional","affiliation":[{"name":"Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA"},{"name":"Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan S.","family":"Dellon","sequence":"additional","affiliation":[{"name":"Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA"},{"name":"Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,12,16]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1111\/apt.12119","article-title":"The natural history of eosinophilic oesophagitis in the transition from childhood to adulthood","volume":"37","author":"P Menard-Katcher","year":"2013","journal-title":"Aliment Pharmacol Ther"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1053\/j.gastro.2017.06.067","article-title":"Epidemiology and natural history of eosinophilic esophagitis","volume":"154","author":"E S 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Hirano","year":"2020","journal-title":"Gastroenterology"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1053\/j.gastro.2019.03.025","article-title":"Efficacy of budesonide orodispersible tablets as induction therapy for eosinophilic esophagitis in a randomized placebo-controlled trial","volume":"157","author":"A J Lucendo","year":"2019","journal-title":"Gastroenterology"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1053\/j.gastro.2019.09.048","article-title":"Developing quality metrics for upper endoscopy","volume":"158","author":"P Sharma","year":"2020","journal-title":"Gastroenterology"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.gie.2015.05.046","article-title":"The esophageal biopsy \"pull\" sign: a highly specific and treatment-responsive endoscopic finding in eosinophilic esophagitis (with video)","volume":"83","author":"E S Dellon","year":"2016","journal-title":"Gastrointest 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Hepatol"}],"container-title":["Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1284-5891.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T05:48:41Z","timestamp":1660110521000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1284-5891"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,6]]},"references-count":33,"journal-issue":{"issue":"09","published-online":{"date-parts":[[2021,8,26]]},"published-print":{"date-parts":[[2021,9]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1284-5891","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0013-726X","1438-8812"],"issn-type":[{"value":"0013-726X","type":"print"},{"value":"1438-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,10,6]]},"published":{"date-parts":[[2020,10,6]]}}}