{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T13:39:53Z","timestamp":1762177193651,"version":"3.41.2"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2019,4,25]],"date-time":"2019-04-25T00:00:00Z","timestamp":1556150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32DK007634","K23DK090073","K24DK100548"],"award-info":[{"award-number":["T32DK007634","K23DK090073","K24DK100548"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11,13]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n               <jats:p>Non-dysphagia symptoms, such as heartburn and dyspepsia, are poorly characterized in adults with eosinophilic esophagitis (EoE). It is unclear if treatment improves these symptoms. The aim of this paper was to assess (i) heartburn and dyspepsia symptom severity in adult EoE patients using validated symptom measures; (ii) change in symptoms after treatment; and (iii) symptom association with endoscopic and histologic features. In a prospective cohort of adult EoE patients who were not responsive to proton pump inhibitor therapy, non-dysphagia symptoms were assessed with heartburn items from the validated GERD-HRQL (gastroesophageal reflux disease health-related quality of life) and SODA (severity of dyspepsia assessment) instruments. Subjects completed the questionnaires at baseline and after treatment. Association of baseline symptoms with endoscopic and histologic features, and before and after treatment with diet or topical steroids, was assessed. Eighty-six EoE patients (mean age 39 years, 57% male, 95% white) completed a baseline questionnaire and 62 completed the follow-up questionnaire. The mean baseline GERD-HRQL score was 4.5 \u00b1 6.5 and the mean total SODA score was 41.0 \u00b1 12.6. At baseline, there was a weak but significant correlation between peak eosinophils and the SODA score (r = 0.28; p = 0.03) and no association between heartburn and SODA scores and endoscopic or other histologic findings. After treatment, there was a decrease in GERD-HRQL heartburn (4.3 vs. 2.6; p = 0.04) and SODA (49.5 vs. 35.5; p = 0.04) scores in histologic responders, but not in nonresponders. In a prospective cohort of EoE patients, baseline eosinophils positively correlated with dyspepsia severity. Heartburn and dyspepsia symptoms improved after treatment in histologic responders.<\/jats:p>","DOI":"10.1093\/dote\/doz028","type":"journal-article","created":{"date-parts":[[2019,4,25]],"date-time":"2019-04-25T12:23:36Z","timestamp":1556195016000},"source":"Crossref","is-referenced-by-count":5,"title":["Heartburn and dyspepsia symptom severity improves after treatment and correlates with histology in adults with eosinophilic esophagitis"],"prefix":"10.1093","volume":"32","author":[{"given":"Swathi","family":"Eluri","sequence":"first","affiliation":[{"name":"Center for Esophageal Diseases and Swallowing"},{"name":"Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irina","family":"Perjar","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renee","family":"Betancourt","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cara","family":"Randall","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soha","family":"Raja","sequence":"additional","affiliation":[{"name":"Center for Esophageal Diseases and Swallowing"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John T","family":"Woosley","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas J","family":"Shaheen","sequence":"additional","affiliation":[{"name":"Center for Esophageal Diseases and Swallowing"},{"name":"Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1167-1101","authenticated-orcid":false,"given":"Evan S","family":"Dellon","sequence":"additional","affiliation":[{"name":"Center for Esophageal Diseases and Swallowing"},{"name":"Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,4,25]]},"reference":[{"key":"2020110312211103800_bib1","first-page":"1593","article-title":"Eosinophilic esophagitis: updated consensus recommendations for children and adults","volume":"128","author":"Liacouras","year":"2011","journal-title":"Gastroenterology"},{"key":"2020110312211103800_bib2","doi-asserted-by":"crossref","first-page":"2627","DOI":"10.1111\/j.1572-0241.2007.01512.x","article-title":"Prevalence and predictive factors of eosinophilic esophagitis in patients presenting with dysphagia: a prospective study","volume":"102","author":"Prasad","year":"2007","journal-title":"Am J Gastroenterol"},{"key":"2020110312211103800_bib3","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1016\/j.gie.2011.06.029","article-title":"Esophageal foreign-body impactions: epidemiology, time trends, and the impact of the increasing prevalence of eosinophilic esophagitis","volume":"74","author":"Sperry","year":"2011","journal-title":"Gastrointest Endosc"},{"key":"2020110312211103800_bib4","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1136\/gutjnl-2014-308815","article-title":"A randomised, double-blind trial comparing budesonide formulations and dosages for short-term treatment of eosinophilic oesophagitis","volume":"65","author":"Miehlke","year":"2016","journal-title":"Gut"},{"key":"2020110312211103800_bib5","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1016\/S1542-3565(05)00885-2","article-title":"Eosinophilic esophagitis: a 10-year experience in 381 children","volume":"3","author":"Liacouras","year":"2005","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2020110312211103800_bib6","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1053\/j.gastro.2012.03.001","article-title":"Elimination diet effectively treats eosinophilic esophagitis in adults; food reintroduction identifies causative factors","volume":"142","author":"Gonsalves","year":"2012","journal-title":"Gastroenterology"},{"key":"2020110312211103800_bib7","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1016\/j.jaci.2011.09.013","article-title":"Escalating incidence of eosinophilic esophagitis: a 20-year prospective, population-based study in Olten County, Switzerland","volume":"128","author":"Hruz","year":"2011","journal-title":"J Allergy Clin Immunol"},{"key":"2020110312211103800_bib8","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/S1081-1206(10)60359-6","article-title":"A symptom scoring tool for identifying pediatric patients with eosinophilic esophagitis and correlating symptoms with inflammation","volume":"103","author":"Aceves","year":"2009","journal-title":"Ann Allergy Asthma Immunol"},{"key":"2020110312211103800_bib9","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1186\/1471-230X-12-135","article-title":"Development of the Pediatric Quality of Life Inventory Eosinophilic Esophagitis module items: qualitative methods","volume":"12","author":"Franciosi","year":"2012","journal-title":"BMC Gastroenterol"},{"key":"2020110312211103800_bib10","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1016\/j.jaci.2015.03.004","article-title":"Pediatric Eosinophilic Esophagitis Symptom Scores (PEESS v2.0) identify histologic and molecular correlates of the key clinical features of disease","volume":"135","author":"Martin","year":"2015","journal-title":"J Allergy Clin Immunol"},{"key":"2020110312211103800_bib11","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1053\/j.gastro.2014.08.028","article-title":"Development and validation of a symptom-based activity index for adults with eosinophilic esophagitis","volume":"147","author":"Schoepfer","year":"2014","journal-title":"Gastroenterology"},{"key":"2020110312211103800_bib12","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1111\/apt.12413","article-title":"Development and field testing of a novel patient-reported outcome measure of dysphagia in patients with eosinophilic esophagitis","volume":"38","author":"Dellon","year":"2013","journal-title":"Aliment Pharmacol Ther"},{"key":"2020110312211103800_bib13","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1111\/dote.12391","article-title":"How to measure disease activity in eosinophilic esophagitis","volume":"29","author":"Schoepfer","year":"2016","journal-title":"Dis Esophagus"},{"key":"2020110312211103800_bib14","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1053\/j.gastro.2015.11.004","article-title":"Symptoms have modest accuracy in detecting endoscopic and histologic remission in adults with eosinophilic esophagitis","volume":"150","author":"Safroneeva","year":"2016","journal-title":"Gastroenterology"},{"key":"2020110312211103800_bib15","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1111\/apt.14061","article-title":"A visual analogue scale and a Likert scale are simple and responsive tools for assessing dysphagia in eosinophilic oesophagitis","volume":"45","author":"Reed","year":"2017","journal-title":"Aliment Pharmacol Ther"},{"key":"2020110312211103800_bib16","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1038\/ajg.2015.239","article-title":"A clinical prediction tool identifies cases of eosinophilic esophagitis without endoscopic biopsy: A prospective study","volume":"110","author":"Dellon","year":"2015","journal-title":"Am J Gastroenterol"},{"key":"2020110312211103800_bib17","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1038\/ajg.2015.57","article-title":"Utility of a noninvasive serum biomarker panel for diagnosis and monitoring of eosinophilic esophagitis: a prospective study","volume":"110","author":"Dellon","year":"2015","journal-title":"Am J Gastroenterol"},{"issue":"18","key":"2020110312211103800_bib18","first-page":"309650","article-title":"Clinical and molecular factors associated with histologic response to topical steroid treatment in patients with eosinophilic esophagitis","volume":"S1542-3565","author":"Eluri","year":"2018","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2020110312211103800_bib19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/dote\/dox111","article-title":"Impact of smoking, alcohol consumption, and NSAID use on risk for and phenotypes of eosinophilic esophagitis","volume":"31","author":"Koutlas","year":"2018","journal-title":"Dis Esophagus"},{"key":"2020110312211103800_bib20","doi-asserted-by":"crossref","first-page":"2088","DOI":"10.1111\/all.13530","article-title":"Association of mast cells with clinical, endoscopic, and histologic findings in adults with eosinophilic esophagitis","volume":"73","author":"Tappata","year":"2018","journal-title":"Allergy"},{"key":"2020110312211103800_bib21","doi-asserted-by":"crossref","first-page":"1854","DOI":"10.1038\/ajg.2013.363","article-title":"Clinical and endoscopic characteristics do not reliably differentiate PPI-responsive esophageal eosinophilia and eosinophilic esophagitis in patients undergoing upper endoscopy: a prospective cohort study","volume":"108","author":"Dellon","year":"2013","journal-title":"Am J Gastroenterol"},{"key":"2020110312211103800_bib22","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1038\/ajg.2013.71","article-title":"ACG clinical guideline: evidenced based approach to the diagnosis and management of esophageal eosinophilia and eosinophilic esophagitis (EoE)","volume":"108","author":"Dellon","year":"2013","journal-title":"Am J Gastroenterol"},{"key":"2020110312211103800_bib23","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1136\/gutjnl-2011-301817","article-title":"Endoscopic assessment of the oesophageal features of eosinophilic oesophagitis: validation of a novel classification and grading system","volume":"62","author":"Hirano","year":"2013","journal-title":"Gut"},{"key":"2020110312211103800_bib24","doi-asserted-by":"crossref","first-page":"1940","DOI":"10.1007\/s10620-009-1005-z","article-title":"Inter- and intraobserver reliability and validation of a new method for determination of eosinophil counts in patients with esophageal eosinophilia","volume":"55","author":"Dellon","year":"2010","journal-title":"Dig Dis Sci"},{"key":"2020110312211103800_bib25","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/S1091-255X(98)80004-8","article-title":"Comparison of generic (SF-36) vs. disease-specific (GERD-HRQL) quality-of-life scales for gastroesophageal reflux disease","volume":"2","author":"Velanovich","year":"1998","journal-title":"J Gastrointest Surg"},{"key":"2020110312211103800_bib26","first-page":"217","article-title":"Quality of life scale for gastroesophageal reflux disease","volume":"183","author":"Velanovich","year":"1996","journal-title":"J Am Coll Surg"},{"key":"2020110312211103800_bib27","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1016\/S0895-4356(00)00365-6","article-title":"SODA (severity of dyspepsia assessment): a new effective outcome measure for dyspepsia-related health","volume":"54","author":"Rabeneck","year":"2001","journal-title":"J Clin Epidemiol"},{"key":"2020110312211103800_bib28","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1111\/j.1572-0241.2002.05419.x","article-title":"Reliability, validity, and responsiveness of severity of dyspepsia assessment (SODA) in a randomized clinical trial of a COX-2-specific inhibitor and traditional NSAID therapy","volume":"97","author":"Rabeneck","year":"2002","journal-title":"Am J Gastroenterol"},{"key":"2020110312211103800_bib29","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1185\/03007995.2014.999152","article-title":"One-year open-label safety evaluation of the fixed combination of ibuprofen and famotidine with a prospective analysis of dyspepsia","volume":"31","author":"Bello","year":"2015","journal-title":"Curr Med Res Opin"},{"key":"2020110312211103800_bib30","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1111\/j.1365-2036.2010.04378.x","article-title":"Clinical trial: the incidence of NSAID-associated endoscopic gastric ulcers in patients treated with PN 400 (naproxen plus esomeprazole magnesium) vs. enteric-coated naproxen alone","volume":"32","author":"Goldstein","year":"2010","journal-title":"Aliment Pharmacol Ther"},{"key":"2020110312211103800_bib31","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1053\/j.gastro.2014.07.055","article-title":"Advances in clinical management of eosinophilic esophagitis","volume":"147","author":"Dellon","year":"2014","journal-title":"Gastroenterology"},{"key":"2020110312211103800_bib32","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.cgh.2017.09.046","article-title":"Optimal histologic cutpoints for treatment response in patients with eosinophilic esophagitis: analysis of data from a prospective cohort study","volume":"16","author":"Reed","year":"2018","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2020110312211103800_bib33","doi-asserted-by":"crossref","first-page":"4123692","DOI":"10.1155\/2016\/4123692","article-title":"Eosinophilic esophagitis in children and adolescents with abdominal pain: comparison with EoE-Dysphagia and functional abdominal pain","volume":"2016","author":"Gunasekaran","year":"2016","journal-title":"Canadian J Gastroenterol Hepatol"},{"key":"2020110312211103800_bib34","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1097\/MPG.0b013e31817f0197","article-title":"Dissociation between symptoms and histological severity in pediatric eosinophilic esophagitis","volume":"48","author":"Pentiuk","year":"2009","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2020110312211103800_bib35","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1053\/j.gastro.2014.04.019","article-title":"Efficacy, dose reduction, and resistance to high-dose fluticasone in patients with eosinophilic esophagitis","volume":"147","author":"Butz","year":"2014","journal-title":"Gastroenterology"},{"key":"2020110312211103800_bib36","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1097\/MPG.0b013e31829ce5ad","article-title":"Psychosocial dysfunction in children and adolescents with eosinophilic esophagitis","volume":"57","author":"Harris","year":"2013","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2020110312211103800_bib37","first-page":"S662","article-title":"Mo1184 pain with swallowing is a frequent and under-appreciated symptom in eosinophilic esophagitis: analysis from a multicenter randomized placebo-controlled trial","volume":"150","author":"Dellon","year":"2016","journal-title":"Gastroenterology"},{"key":"2020110312211103800_bib38","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1016\/j.cgh.2007.07.025","article-title":"An eosinophil hypothesis for functional dyspepsia","volume":"5","author":"Rothenberg","year":"2007","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2020110312211103800_bib39","doi-asserted-by":"crossref","first-page":"G482","DOI":"10.1152\/ajpgi.00374.2014","article-title":"Allergen challenge sensitizes TRPA1 in vagal sensory neurons and afferent C-fiber subtypes in guinea pig esophagus","volume":"308","author":"Liu","year":"2015","journal-title":"Am J Physiol Gastrointest Liver Physiol"},{"key":"2020110312211103800_bib40","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1038\/86365","article-title":"A pathological function for eotaxin and eosinophils in eosinophilic gastrointestinal inflammation","volume":"2","author":"Hogan","year":"2001","journal-title":"Nat Immunol"},{"key":"2020110312211103800_bib41","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1016\/j.cgh.2012.03.018","article-title":"Swallowed fluticasone improves histologic but not symptomatic response of adults with eosinophilic esophagitis","volume":"10","author":"Alexander","year":"2012","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2020110312211103800_bib42","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.cgh.2014.05.021","article-title":"Efficacy and safety of oral budesonide suspension in pediatric patients with eosinophilic esophagitis","volume":"13","author":"Gupta","year":"2015","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2020110312211103800_bib43","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.1053\/j.gastro.2011.07.044","article-title":"An antibody against IL-5 reduces numbers of esophageal intraepithelial eosinophils in children with eosinophilic esophagitis","volume":"141","author":"Assa\u2019ad","year":"2011","journal-title":"Gastroenterology"}],"container-title":["Diseases of the Esophagus"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/dote\/article-pdf\/32\/9\/doz028\/34116466\/doz028.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/dote\/article-pdf\/32\/9\/doz028\/34116466\/doz028.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,3]],"date-time":"2020-11-03T17:21:38Z","timestamp":1604424098000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/dote\/article\/doi\/10.1093\/dote\/doz028\/5479248"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4,25]]},"references-count":43,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2019,4,25]]},"published-print":{"date-parts":[[2019,11,13]]}},"URL":"https:\/\/doi.org\/10.1093\/dote\/doz028","relation":{},"ISSN":["1120-8694","1442-2050"],"issn-type":[{"type":"print","value":"1120-8694"},{"type":"electronic","value":"1442-2050"}],"subject":[],"published-other":{"date-parts":[[2019,9]]},"published":{"date-parts":[[2019,4,25]]},"article-number":"doz028"}}