Eosinophilic Oesophagitis Beyond the Oesophagus: High Prevalence of Chronic Rhinosinusitis-Type Symptoms and Their Impact on Symptom Severity in Swiss EoE Cohort Study Patients.

BACKGROUND

Both eosinophilic oesophagitis (EoE) and chronic rhinosinusitis (CRS) are type 2 inflammatory conditions sharing pathogenic mechanisms, therapeutic responses and atopic associations. Data on the prevalence of CRS in EoE patients is missing.

AIMS: Our aim was to assess the prevalence of CRS-type symptoms in EoE patients, the quality of life and shared characteristics of patients with both diseases.

METHODS

We assessed the point prevalence of CRS in Swiss Eosinophilic Esophagitis Cohort Study patients using a validated screening questionnaire comprising four symptom-based diagnostic criteria. CRS was defined based on symptoms only (definition A) and including self-reported CRS diagnosis by a physician (definition B). Point prevalence was tested against population prevalence using two-sided binomial tests. Secondary outcomes were compared between patients with and without CRS. Multivariable logistic regression models were built to adjust for confounders.

RESULTS

211 patients (54%) answered our questionnaire. Prevalence of CRS-type symptoms was 21.8% (definition A) or 25.1% (definition B), compared to 8.71% in the general population (p < 0.0001). CRS status was associated with increased EoE symptom severity. This association persisted after adjustment in multivariable logistic models, most consistently under definition A. 25% reported that their CRS symptoms were more debilitating than their EoE symptoms.

CONCLUSION

CRS-type symptoms are two- to three times more prevalent in EoE patients than in the general population and substantially impact quality of life. Our findings indicate that CRS may be under-diagnosed in EoE and support routine CRS screening in EoE patients and cross-speciality collaboration, particularly as both conditions benefit from therapeutic strategies targeting type 2 inflammation.