Rising Incidence and Prevalence of Eosinophilic Esophagitis in the United Arab Emirates, Comorbidities, and Clinical Outcomes: A Single-Center Cohort Study
This single-center cohort study from the United Arab Emirates reveals a dramatic increase in the incidence and prevalence of eosinophilic esophagitis between 2019 and 2024, characterizing a patient population with symptoms and demographics similar to global trends while highlighting the superior histologic response observed in patients treated with biologic therapies.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Imagine a narrow, muscular tube that carries food from your throat to your stomach. For most people, this tube works without a second thought, but for some, it becomes the site of a quiet, chronic struggle. This condition is called eosinophilic esophagitis. It is an immune system reaction where a specific type of white blood cell, known as an eosinophil, builds up in the lining of the esophagus. These cells are usually found in the nose or lungs when fighting allergies, but when they gather in the esophagus, they cause inflammation. Over time, this swelling can make the tube stiff and narrow, turning a simple meal into a difficult event where food gets stuck or causes pain. While doctors have known about this condition for decades and have seen its numbers rise steadily in Western countries, the picture in the Middle East remained largely a blank spot on the map.
A team of researchers at Sheikh Shakhbout Medical City in Abu Dhabi decided to fill in that gap. They looked back at patient records from 2019 through 2025 to understand how this disease is affecting people in the United Arab Emirates. Their goal was not just to count cases, but to see who was getting sick, what symptoms they had, and how well different treatments worked in their local population. By gathering this information from a single, large hospital that serves a wide area, they hoped to create a clear portrait of the disease in a region where data had been scarce.
The results revealed a story of rapid change. In 2019, the researchers found that for every 100,000 people in their hospital's service area, only two new cases of this condition were diagnosed. By 2024, that number had jumped to nearly five cases for every 100,000 people. This represents a massive increase in how often the disease is being found, growing more than twenty-three times over just five years. The total number of people living with the condition in that area also rose sharply, climbing from two people per 100,000 to seventeen per 100,000. The researchers believe this surge is likely due to a combination of factors: doctors are becoming better at recognizing the signs, and they are more willing to take small tissue samples, called biopsies, to confirm the diagnosis when they suspect something is wrong.
When the team examined the 102 patients they identified, they found a group that looked very much like patients described in studies from Europe and North America. The average age at diagnosis was about 26 years old, and nearly seven out of ten patients were men. The most common complaint was difficulty swallowing, which affected two-thirds of the group, followed by food getting stuck in the throat, which happened to about one-third of the patients. Many of these individuals also suffered from other allergic conditions, such as hay fever, asthma, or food allergies, suggesting that their immune systems were prone to overreacting to their environment.
The study also explored how this condition interacts with another common digestive issue: acid reflux, where stomach acid flows back up into the esophagus. More than half of the patients had a diagnosis of acid reflux alongside their esophageal condition. Interestingly, the researchers noticed a distinct difference in how these two groups were managed. Patients who had the esophageal condition without acid reflux were more likely to need a procedure to stretch out a narrowed part of their esophagus. This suggests that without the presence of acid reflux, the tissue might become stiff and narrow more quickly. Conversely, those with acid reflux were more likely to be treated with medications that reduce stomach acid, which is a standard first step for many digestive issues.
Treatment outcomes offered another layer of insight. The most common first treatment was a medication that lowers stomach acid, but for those who did not improve, doctors turned to other options like special diets or swallowed steroid sprays. A small but significant group of patients received a newer type of medicine known as a biologic, which targets specific parts of the immune system to stop the inflammation. The data showed that patients treated with these biologic medicines had a much higher rate of success in reducing the number of inflammatory cells in their esophagus compared to those who did not receive them. While the number of patients on this specific treatment was small, the trend was clear: those who received it saw their tissue heal more effectively.
The researchers concluded that this condition is an emerging health issue in the Middle East, growing in frequency just as it has elsewhere in the world. The people suffering from it share the same characteristics and symptoms as patients globally, but the region is only just beginning to understand the full scope of the problem. The study highlights that while the disease is becoming more visible, there is still work to be done in standardizing how it is diagnosed and treated. By recognizing the patterns in their local population, doctors in the UAE can now move forward with better tools to help patients swallow comfortably and live without the constant worry of food getting stuck.
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