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

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.