Eosinophilic Esophagitis in a Latin American Population: Results of an Observational Study Based on an Institutional Registry of a Referral Center

Abstract

Introduction. Eosinophilic esophagitis is poorly characterized in Latin America. We aimed to estimate its prevalence and describe its clinical, endoscopic, and histologic features, treatments, remission rates, and associated factors.

Materials and Methods. Cross-sectional analysis of a retrospective-prospective registry. Adults with confirmed eosinophilic esophagitis diagnosed between 2014 and 2025 were included, defined by symptoms of esophageal dysfunction and ≥15 eosinophils per high-power field. Factors associated with histologic remission were explored using logistic regression.

Results. A total of 129 adults were included (72.9% male; median age, 43 years). The prevalence was 36 per 100,000 health plan members (95% CI, 27–47), and the median diagnostic delay was 8.21 months. The most common presenting symptoms were dysphagia (75.1%) and food impaction (63.2%). The most frequent endoscopic findings were furrows (30.4%), edema (24.9%), and rings (23.4%), while 49% of patients had a normal endoscopic examination. Treatments included proton pump inhibitors (88%), topical corticosteroids (45%), and an elimination diet (39%). Clinical remission was achieved in 51.2% of patients, whereas histologic remission was achieved in 34.3%. Food sensitization was independently associated with histologic remission (adjusted odds ratio, 3.31; 95% CI, 1.26–8.73; p = 0.015). Among patients who achieved histologic remission, 28% continued to have an incomplete clinical response.

Conclusion. The local prevalence was at the lower end of the pooled global estimate (40.04; 95% CI, 31.10–48.98) and below the estimate for the 2017–2022 period (74.42; 95% CI, 39.66–109.19), as well as contemporary estimates from the United States and Spain, although these comparisons should be interpreted with methodological and population-related caveats. The high proportion of normal endoscopic examinations reinforces the need to obtain esophageal biopsies whenever eosinophilic esophagitis is clinically suspected. Histologic remission in only one-third of cases highlights the need to optimize treatment strategies and long-term follow-up.