While symptom scores have been developed to evaluate dysphagia in eosinophilic esophagitis, their complexity may limit clinical use.

Dr Dellon and colleagues from North Carolina, USA evalauted a visual analogue scale, and a 10-point Likert scale for assessment of dysphagia severity before and after eosinophilic esophagitis treatment.

The team conducted a prospective cohort study enrolling consecutive adults undergoing out-patient endoscopy. 

Incident cases of eosinophilic esophagitis were diagnosed per consensus guidelines. 

At diagnosis and after 8 weeks of treatment, symptoms were measured using the visual analogue scale, Likert scale and the Mayo Dysphagia Questionnaire (MDQ). 

The percentage change in scores before and after treatment were compared overall, in treatment responders and non-responders, and in patients without baseline dilation.

In 71% of eosinophilic esophagitis cases, the median visual analogue scale decreased from 4 at baseline to 1 post-treatment, the Likert scale decreased by 67% and the MDQ decreased by 49%. 

The visual analogue scale correlated with both the Likert scale, and MDQ. 

After stratification by histological response, the Likert scale decreased 70% in responders vs. 13% in non-responders. 

In patients who did not receive baseline dilation, both the visual analogue scale, and Likert scale decreased significantly more in the histological responders.

Dr Both the visual analogue scale and Likert scale were responsive to successful treatment as measured by histologic improvement. 

Dr Dellon's concludes, "Because the visual analogue scale and Likert scale are simple to administer and are responsive to treatment, they can provide an efficient and objective method for assessing dysphagia severity in eosinophilic esophagitis in clinical practice."