Underlying Diagnosis of Food Bolus Obstruction Acute Admissions to Otorhinolaryngology: A Shift to Provide the Best Care as per the Current Guidelines
<i>Background and Objectives:</i> In the United Kingdom, some patients with food bolus obstruction (FBO) are admitted under the care of ear, nose, and throat (ENT) doctors. In the literature, eosinophilic oesophagitis (EoE) is the most common cause of FBO. We analysed ENT FBO admissions...
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MDPI AG
2025-06-01
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| author | Rasads Misirovs Anna Kamusella Michael Miller Samit Majumdar |
| author_facet | Rasads Misirovs Anna Kamusella Michael Miller Samit Majumdar |
| author_sort | Rasads Misirovs |
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| description | <i>Background and Objectives:</i> In the United Kingdom, some patients with food bolus obstruction (FBO) are admitted under the care of ear, nose, and throat (ENT) doctors. In the literature, eosinophilic oesophagitis (EoE) is the most common cause of FBO. We analysed ENT FBO admissions and interventions used in our hospital to investigate for EoE. <i>Materials and Methods:</i> This paper details a retrospective study of adult FBO admissions to an ENT ward from January 2016 to December 2019 at a single centre. <i>Results:</i> In total, 120 patients were admitted. Half of the patients required instrumentation to resolve the obstruction—31% underwent rigid oesophagoscopy (RO) and 69% oesophagogastroduodenoscopy (OGD). Biopsies were taken during 48% of inpatient OGDs and 5% of ROs. 48% had a histopathological diagnosis of EoE. There was no mention of a specific number of eosinophils per high-power field in 53% of EoE pathology reports. Potentially, some patients were EoE-negative due to an inadequate number of biopsies taken—71% of patients had an insufficient number of biopsies to exclude EoE. A total of 56% of all patients with FBO did not undergo inpatient or outpatient OGDs with biopsies. <i>Conclusions:</i> Biopsies were not taken in all FBO patients undergoing oesophagoscopy, leaving EoE underdiagnosed. Follow-up arrangements were often suboptimal to exclude EoE. |
| format | Article |
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| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2025-06-01 |
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| spelling | doaj-art-fa25ffab5a3a4a5c9d0eb1e6604cd8552025-06-25T14:09:43ZengMDPI AGMedicina1010-660X1648-91442025-06-01616104710.3390/medicina61061047Underlying Diagnosis of Food Bolus Obstruction Acute Admissions to Otorhinolaryngology: A Shift to Provide the Best Care as per the Current GuidelinesRasads Misirovs0Anna Kamusella1Michael Miller2Samit Majumdar3Department of Otorhinolaryngology, NHS Lothian, Edinburgh EH16 4SA, UKDepartment of Psychiatry, Edinburgh, NHS Lothian, Edinburgh EH10 5HF, UKDepartment of Gastroenterology, Ninewells Hospital & Medical School, NHS Tayside, Dundee DD1 9SY, UKDepartment of Otorhinolaryngology, Ninewells Hospital & Medical School, NHS Tayside, Dundee DD1 9SY, UK<i>Background and Objectives:</i> In the United Kingdom, some patients with food bolus obstruction (FBO) are admitted under the care of ear, nose, and throat (ENT) doctors. In the literature, eosinophilic oesophagitis (EoE) is the most common cause of FBO. We analysed ENT FBO admissions and interventions used in our hospital to investigate for EoE. <i>Materials and Methods:</i> This paper details a retrospective study of adult FBO admissions to an ENT ward from January 2016 to December 2019 at a single centre. <i>Results:</i> In total, 120 patients were admitted. Half of the patients required instrumentation to resolve the obstruction—31% underwent rigid oesophagoscopy (RO) and 69% oesophagogastroduodenoscopy (OGD). Biopsies were taken during 48% of inpatient OGDs and 5% of ROs. 48% had a histopathological diagnosis of EoE. There was no mention of a specific number of eosinophils per high-power field in 53% of EoE pathology reports. Potentially, some patients were EoE-negative due to an inadequate number of biopsies taken—71% of patients had an insufficient number of biopsies to exclude EoE. A total of 56% of all patients with FBO did not undergo inpatient or outpatient OGDs with biopsies. <i>Conclusions:</i> Biopsies were not taken in all FBO patients undergoing oesophagoscopy, leaving EoE underdiagnosed. Follow-up arrangements were often suboptimal to exclude EoE.https://www.mdpi.com/1648-9144/61/6/1047oesophagogastroduodenoscopydysphagiaswallowing disordereosinophilic esophagitisbiopsy |
| spellingShingle | Rasads Misirovs Anna Kamusella Michael Miller Samit Majumdar Underlying Diagnosis of Food Bolus Obstruction Acute Admissions to Otorhinolaryngology: A Shift to Provide the Best Care as per the Current Guidelines Medicina oesophagogastroduodenoscopy dysphagia swallowing disorder eosinophilic esophagitis biopsy |
| title | Underlying Diagnosis of Food Bolus Obstruction Acute Admissions to Otorhinolaryngology: A Shift to Provide the Best Care as per the Current Guidelines |
| title_full | Underlying Diagnosis of Food Bolus Obstruction Acute Admissions to Otorhinolaryngology: A Shift to Provide the Best Care as per the Current Guidelines |
| title_fullStr | Underlying Diagnosis of Food Bolus Obstruction Acute Admissions to Otorhinolaryngology: A Shift to Provide the Best Care as per the Current Guidelines |
| title_full_unstemmed | Underlying Diagnosis of Food Bolus Obstruction Acute Admissions to Otorhinolaryngology: A Shift to Provide the Best Care as per the Current Guidelines |
| title_short | Underlying Diagnosis of Food Bolus Obstruction Acute Admissions to Otorhinolaryngology: A Shift to Provide the Best Care as per the Current Guidelines |
| title_sort | underlying diagnosis of food bolus obstruction acute admissions to otorhinolaryngology a shift to provide the best care as per the current guidelines |
| topic | oesophagogastroduodenoscopy dysphagia swallowing disorder eosinophilic esophagitis biopsy |
| url | https://www.mdpi.com/1648-9144/61/6/1047 |
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