A0197 - Incidence of Food Impaction Based Upon Region and Season in the United States

Sunday, October 23, 2022

5:00 PM – 7:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Ammar Ahmad, MD

Wright State University Boonshoft School of Medicine
Tipp City, OH

Ammar Ahmad, MD¹, Brian Dinh, MD¹, Sangeeta Agrawal, MD²
¹Wright State University Boonshoft School of Medicine, Dayton, OH; ²Dayton VA Medical Center, Dayton, OH

Introduction: Food impactions frequently occur as result of underling functional or mechanical pathology such as rings, strictures, webs, malignancies, eosinophilic esophagitis (EoE), or dysmotility. The primary aim of this study was to evaluate seasonal and regional variation in the incidence of esophageal food bolus impaction.

Methods: Data were collected for patients admitted for esophageal food impaction from National Hospital Discharge Survey (NHDS) between 2001 and 2010 and National Hospital Ambulatory Medical Care Survey (NHAMCS) between 2011 and 2015. Demographics, region, and month of admission were collected. SPSS was used for chi-square testing at alpha of 0.05 to compare incidence of esophageal impaction based on region and season. Seasons were defined as follows: Winter (December to February), Spring (March to May), Summer (June to August), and Fall (September to November). Four regions were identified and included Northeast, Midwest, South, and West (Figure 1). Data was adjusted for distribution of US population.

Results: In total, 602 cases of food bolus impaction were identified. Older patients (Age > 50) had higher incidence of food bolus impaction (p < 0.001). Male sex was found to be an independent risk factor for food bolus impaction (p < 0.001). No difference was noted based on race of patients (p = 0.07). Northeast had the highest number of cases and west had the least number of cases of food bolus impaction (p < 0.001). Cases in northeast were significantly more than Midwest and South as well (p < 0.001). The highest number of food bolus cases were noted in summer and the least number of cases were noted in winter. The difference between summer vs winter (p < 0.01), and summer vs spring (p = 0.01) was statistically significant. The difference between summer and fall (p = 0.28) was not statistically significant.

Discussion: Food impactions occur for a wide variety of reasons with EoE being one of the most common cause of food impactions. Previous studies have documented seasonal variations of EoE, but none, known to date, have evaluated this finding in the United States. Interestingly, in our study, the Northeast did have significantly more cases compared to the South, West, and Midwest. Summer months had a high propensity for food impactions as well. This difference may be due to environmental factors and should be investigated further.

Figure: Figure 1: Distribution of States by Region

Region	No. of Cases	% of Cases
Northeast	201	33.4%
Midwest	145	24.1%
South	191	31.7%
West	65	10.8%
Comparison between Regions		p-value
Northeast vs. Midwest	33.4% vs. 24.1%	< 0.001
Northeast vs. South	33.4% vs. 31.7%	< 0.001
Northeast vs. West	33.4% vs. 10.8%	< 0.001
Midwest vs. South	24.1% vs. 31.7%	0.002
Midwest vs. West	24.1% vs. 10.8%	< 0.001
South vs. West	31.7% vs. 10.8%	< 0.001
Season	No. of Cases	% of cases
Winter	131	21.8%
Spring	132	21.9%
Summer	180	29.9%
Fall	159	26.4%
Comparison between Seasons		p-value
Spring vs. Winter	21.9% vs. 21.8%	0.9
Summer vs. Winter	29.9% vs. 21.8%	< 0.01
Fall vs. Winter	26.4% vs. 21.8%	0.1
Summer vs. Spring	29.9% vs. 21.9%	0.01
Summer vs. Fall	29.9% vs. 26.4%	0.28
Fall vs. Spring	26.4% vs. 21.9%	0.13

Table: Table 1: Comparison of esophageal food impaction cases based on seasons and region

Disclosures:

Ammar Ahmad indicated no relevant financial relationships.

Brian Dinh indicated no relevant financial relationships.

Sangeeta Agrawal indicated no relevant financial relationships.

Ammar Ahmad, MD¹, Brian Dinh, MD¹, Sangeeta Agrawal, MD². A0197 - Incidence of Food Impaction Based Upon Region and Season in the United States, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.