Eosinophilic esophagitis (EoE) is an immune-mediated inflammatory esophageal disease. In chronic cases, fibrostenotic phenotype manifests, with esophageal stenosis (ES) that benefit from endoscopic dilation as well as optimization of medical treatment. However, recent guidelines do not establish the prevalence of such ES. We wanted to analyze our prevalence of ES, the need of treatment in these patients and how such endoscopic dilation was performed.

We collected retrospective data from our patients with a EoE diagnosis in our hospital since 2020. Their clinical reports and endoscopic reports were reviewed. If an ES was described, the endoscopic report and its images were examined. Patients with Schatzki’s rings were excluded, since its pathophysiology and response to treatment differ from ES in the context of EoE.

Out of 186 patients with an EoE diagnosis, 30 patients were initially screened with an ES. After revision, 14 patients were excluded with an endoscopic diagnosis of Schatzki’s ring and 16 patients were confirmed to have an ES in the context of EoE (ES-EoE), leading to a prevalence of 8.6% of patients with EoE in our center. Only 7 patients received endoscopic dilation treatment of their ES, amounting up to 3.7% of our center’s patients. 

In 3 of our patients, the diagnosis of EoE was established after the diagnosis and treatment of the ES. Esophageal biopsies were taken after the procedure leading up to EoE diagnosis.

Demographic, clinical and endoscopic characteristics of these patients are summarized in Table 1. There was a predominance of male patients (71.42%) with a mean age of 41.85 years of age. Both the median and mode were 1-2 sessions of endoscopic dilation. No complications were described and a subjective clinical improvement was reported in all of our patients. All of our patients had a change of treatment after the treatment, with 14% of them receiving benralizumab with compassive intention and 42.85% of them receiving topical budesonide, while some patients needed an optimization of proton pump inhibitor (PPI) dosage.

ES-EoE amount up to 8.6% of patients with EoE in our center. 3.7% of patients with ES-EoE need endoscopic treatment, with clinical response and no adverse effects were described. After endoscopic dilation, 57% of the patients needed a change of treatment. Endoscopic dilation in ES-EoE is a safe procedure with a small rate of complications.