{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T04:19:39Z","timestamp":1775881179563,"version":"3.50.1"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2021,5,13]],"date-time":"2021-05-13T00:00:00Z","timestamp":1620864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Esophageal food impaction (EFI) is often the first presentation for patients with eosinophilic esophagitis (EoE); however, there is significant heterogeneity in the management of EFI. We aimed to study the impact of EFI management, particularly post-EFI medication prescriptions on EoE diagnosis, follow-up, and recurrence in patients with endoscopic features of EoE. In our retrospective study, adults presenting between 2007 and 2017 with EFI requiring endoscopic dis-impaction with endoscopic features of EoE (furrows, rings, and\/or exudates) were included. We examined the impact of demographics and EFI management on EoE diagnosis, follow-up (esophagogastroduodenoscopy [EGD] or clinic visit within 6\u00a0months), and recurrence. We identified 164 cases of EFI due to suspected EoE. Biopsy was performed in 68 patients (41.5%), and 144 patients (87.8%) were placed on proton pump inhibitor (PPI) and\/or swallow corticosteroids after EFI, including 88.5% of those not biopsied. PPI use at time of biopsy was negatively associated with EoE diagnosis (odds ratio: 0.39, confidence interval: 0.17\u20130.85). Sixty-one (37.4%) patients were lost to follow-up at 6\u00a0months. Recurrent EFI at 1\u00a0year occurred in 3.7% of patients. Medications, most commonly PPI, are frequently prescribed after EFI when the endoscopic features of EoE are present, which may mask the diagnosis of EoE on follow-up EGD. We estimated that for every five patients biopsied on PPI, one case of EoE is masked. As recurrent EFI within 1\u00a0year is uncommon, empiric therapy should be avoided until diagnostic biopsies are obtained. Further efforts to reduce loss to follow-up after EFI are also needed.<\/jats:p>","DOI":"10.1093\/dote\/doab030","type":"journal-article","created":{"date-parts":[[2021,5,14]],"date-time":"2021-05-14T05:26:57Z","timestamp":1620970017000},"source":"Crossref","is-referenced-by-count":15,"title":["Empiric proton pump inhibitor therapy after esophageal food impaction may mask eosinophilic esophagitis diagnosis at follow-up"],"prefix":"10.1093","volume":"34","author":[{"given":"Luke","family":"Hillman","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Donohue","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aimee Teo","family":"Broman","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Medical Informatics, University of Wisconsin\u2013Madison, Madison, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Hoversten","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Gaumnitz","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis","family":"Lomeli","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,5,13]]},"reference":[{"issue":"7","key":"2021111717294301900_ref1","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1016\/S0016-5107(05)00313-5","article-title":"Association of eosinophilic inflammation with esophageal food impaction in adults","volume":"61","author":"Desai","year":"2005","journal-title":"Gastrointest Endosc"},{"issue":"2","key":"2021111717294301900_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":"Dellon","year":"2018","journal-title":"Gastroenterology"},{"issue":"11","key":"2021111717294301900_ref3","doi-asserted-by":"crossref","first-page":"3181","DOI":"10.1007\/s10620-015-3723-8","article-title":"Esophageal food impaction and eosinophilic esophagitis: a retrospective study, systematic review, and 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affects identification of eosinophilic esophagitis","volume":"63","author":"Hiremath","year":"2018","journal-title":"Dig Dis Sci"},{"issue":"12","key":"2021111717294301900_ref7","doi-asserted-by":"crossref","DOI":"10.1093\/dote\/doz056","article-title":"Loss to follow-up after food impaction among patients with and without eosinophilic esophagitis","volume":"32","author":"Chang","year":"2019","journal-title":"Dis Esophagus"},{"issue":"4","key":"2021111717294301900_ref8","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1053\/j.gastro.2018.07.009","article-title":"Updated international consensus diagnostic criteria for eosinophilic esophagitis: proceedings of the AGREE conference","volume":"155","author":"Dellon","year":"2018","journal-title":"Gastroenterology"},{"issue":"9","key":"2021111717294301900_ref9","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1016\/j.cgh.2012.04.019","article-title":"The prevalence and diagnostic utility of endoscopic features of 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