Food-induced Immediate Response of the Esophagus - a newly identified Syndrome in Patients with Eosinophilic Esophagitis

BACKGROUND Dysphagia is the main symptom of adult EoE. We describe a novel syndrome, referred to as "Food-induced Immediate Response of the Esophagus" (FIRE), observed in EoE patients. METHODS FIRE is an unpleasant/painful sensation, unrelated to dysphagia, occurring immediately after esophageal contact with specific foods. EoE experts were surveyed to estimate the prevalence of FIRE, characterize symptoms and identify food triggers. We also surveyed a large group of EoE patients enrolled in the Swiss EoE Cohort Study (SEECS) for FIRE RESULTS: Response rates were 82% (47/57) for the expert- and 65% (239/368) for the patient-survey, respectively. Almost 90% of EoE experts had observed the FIRE symptom-complex in their patients. Forty percent of EoE patients reported experiencing FIRE, more commonly in patients who developed EoE symptoms at a younger age (mean age of 46.4 vs. 54.1 years without FIRE; p