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Spare the H. pylori and spoil the esophagus?

Eosinophilic esophagitis (EoE) is a condition that causes swallowing problems, particularly in younger patients. EoE, which is believed to result from allergic processes, has dramatically increased in frequency in the last decade, but the reasons for this increase remain unknown.

After a series of epidemiologic articles and presentations at national gastroenterology meetings, in which they detailed the frequency of EoE in various United States populations, Researchers Genta and Lash of Miraca Life Sciences, in collaboration with Evan Dellon and other researchers from the Center for Esophageal Diseases and Swallowing of the University of North Carolina School of Medicine, Chapel Hill, NC, made a discovery that may help better understand the recent increase in EoE.

In a paper just published in Gastroenterology, the authors investigated about 8,000 patients with EoE and 155,000 subjects without this condition, all of whom had their biopsy specimens diagnosed at Miraca Life Sciences. They found that H. pylori infection was inversely associated with esophageal eosinophilia.

Since H. pylori infection of the stomach has been declining in the United States for several years, the authors suspect that the decreasing exposure to H. pylori may have resulted in a greater incidence of allergic conditions, including EoE.

Even if this proves to be correct, the authors warn that this is an epidemiologic study, and no individual patient should think that having a gastric infection is good because it prevents eosinophilic esophagitis!

Inverse association of esophageal eosinophilia with Helicobacter pylori based on analysis of a US pathology database.

Dellon ES, Peery AF, Shaheen NJ, Morgan DR, Hurrell JM, Lash RH, Genta RM.

Gastroenterology, Jul 12 2011 (epub)

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