Eosinophilic esophagitis and its association with food allergies: A United States national analysis 2016 to 2022

Abstract

Background Eosinophilic esophagitis (EoE) has known associations with allergic conditions. Previous studies have reported an increased frequency of EoE in patients with IgE-mediated food allergies (FA), however, statistical validation in large inpatient cohorts remains limited. Methods and Findings A retrospective analysis was performed using the National Inpatient Sample (NIS) database from 2016 to 2022. International Classification of Diseases, 10th Revision (ICD-10) codes were used to identify patients with a primary or secondary diagnosis of EoE and FA. Multivariable logistic regression was performed to assess the relationship between EoE and FA. Multivariable regression analysis showed a strong association between EoE and milk (aOR: 7.52, p < 0.001), egg (aOR: 4.77, p < 0.001), peanut (aOR: 3.94, p < 0.001), and seafood allergy (aOR: 2.57, p < 0.001). Among patients with a FA studied, Black (aOR: 0.47, p = 0.001) and Hispanic (aOR: 0.45, p = 0.001) patients had lower odds of EoE compared to White patients. Patients aged 45–64 (aOR: 0.18, p = 0.001) and over 65 (aOR: 0.06, p = 0.001) years with FA had decreased odds of EoE compared to patients under 18. Patients in the highest household zip code income quartile (≥ $86,000) had the greatest odds of EoE (aOR: 1.79, p = 0.001) when compared to the lowest quartile. Conclusions Our study supports a strong association between EoE and milk, egg, peanut, and seafood allergies, and the findings across demographics show notable disparities.