Sloughing Esophagitis

BACKGROUND: Sloughing esophagitis is thought to affect older, debilitated individuals, especially with comorbid disease. It classically exhibits white endoscopic plaques or membranes grossly and is diagnosed histologically by the sloughing of damaged cells with normal underlying mucosa. GOALS: We sought to describe the clinical manifestations and associations of sloughing esophagitis in the largest cohort to date. STUDY: A large institutional database was searched for a diagnosis of sloughing esophagitis to identify patients. Corresponding endoscopy reports were reviewed. Historical and disease course data was extracted from the electronic medical record. RESULTS: We identified 115 individuals with sloughing esophagitis. The most common EGD indication was dysphagia (31%). Classic endoscopic findings were present in 47%. The average Charlson comorbidity index score was 4.1, and individuals were prescribed 12.3 medications on average. SNF placement was recommended for 25 (22%) individuals, and 84 (78%) survived for ≥2 years following diagnosis. Symptoms and endoscopic findings resolved in 77% and 83% of cases, respectively, which was independent of treatment utilization. DISCUSSION: Sloughing esophagitis has a variable endoscopic appearance and is associated with debilitation and polypharmacy. It may resolve spontaneously without pharmacotherapy, which may suggest a transient, self-limiting clinical course.