The study’s goal was to see if patients with eosinophilic esophagitis (EoE) have lower bone mineral density (BMD) than predicted, and if bone deficiencies are more evident in certain patient subgroups based on comorbidities or therapies. For patients with EoE aged 3 to 21 years who underwent a lumbar spine dual-energy x-ray absorptiometry scan, a retrospective file review was done to gather clinical data, including length of diagnosis, comorbidities, and methods of therapy. BMD was normalized by calculating age, gender, and race-specific z scores. The study’s criteria were satisfied by 269 patients in total. The mean BMD z score was lower than predicted, and the prevalence of having a low BMD z score was higher than expected. BMD z scores were 0.27 lower in those on an elimination diet and 0.65 lower in those who had used a proton pump inhibitor at some point in their lives in multivariable regression models. There was no link between steroid usage and swallowing.

Pediatric patients with EoE had a slightly lower BMD z score than peers in our study, and the incidence of poor BMD was greater than predicted. Given the limits of our sample, risk variables for bone deficiencies included any lifetime use of a proton pump inhibitor and a rigorous elimination diet, but not steroid usage taken orally. Larger prospective studies are needed to better describe risk factors for low BMD in order to assist improve screening, therapy selection, and anticipatory advice for patients with EoE.