Background: Food-induced immediate response of the esophagus (FIRE) is a new phenomenon that has been described in eosinophilic esophagitis (EoE) patients. It is suspected when unpleasant symptoms occur suddenly on contact of the triggering food with the esophageal surface and recur with repeated exposures. It can often be mistaken for pollen-food allergy syndrome (PFAS) and solid food dysphagia. Data on FIRE is limited to one survey study and case reports, and there are no screening studies conducted on either adults or children with EoE. In this study, we aimed to screen children aged ≥7 years old with EoE for FIRE. Methods: Demographic data were collected from medical records. A questionnaire about FIRE was applied to all participants. Skin prick tests (SPTs) were done on suspected patients to identify the triggering foods. FIRE is defined as suitable clinical symptoms with suspected food allergen exposure. Results: Seventy-eight patients (74.4% male, median age: 13.5 years) were included. Unpleasant and recurrent symptoms distinct from dysphagia with specific foods were reported in %16.7 of the patients, all of whom had concomitant allergic rhinitis (AR). The symptoms described by almost all patients were oropharyngeal itching and tingling (PFAS: 15.3%) excluding only one patient reporting retrosternal narrowing and pressure after specific food consumption (FIRE: 1.2%). Conclusions: Although definitive conclusions regarding the true prevalence of FIRE cannot be made, it does not seem to be common as PFAS. However, it deserves questioning particularly in the presence of concurrent AR and/or PFAS in children with EoE.

Background While the Pediatric Quality of Life Inventory™ (PedsQL™) 3.0 eosinophilic esophagitis (EoE) Module is widely used for EoE assessment, no comprehensive transcultural adaptation has been completed, except for one linguistic validation study in Spanish. To assess the transcultural adaptation of the Turkish version of PedsQL™ (Tr-PedsQL™) 3.0 EoE Module for teens and parent reports through validity and reliability tests, marking a first in the field. Methods Teens with EoE and their parents were included in the study. Linguistic validation, content validity (CnV) and field test for construct validity (CsV) and reliability were completed in the adaptation of the Tr-PedsQL™ 3.0 EoE Module. Convergent and divergent validity (CgV and DgV) were examined for CsV by correlation analysis between Turkish version of Pediatric EoE Symptom Scores® (Tr-PEESS) v2.0 and Tr-PedsQL TM 3.0 EoE Module scores. Reliability was determined through internal consistency (Cronbach-α) and test-retest reliability (intraclass correlation coefficients: ICC). Results Thirty-three teens and their parents completed the study. CnV indexes were > 0.8 for all items. Good correlations between Tr-PEESS v2.0 and Tr-PedsQL TM 3.0 EoE Module Total, Symptoms I, II and Total scores substantiated CgV, while low or absent correlations in certain dimensions evidenced DgV. Tr-PedsQL TM 3.0 EoE Module showed good internal consistency (Cronbach-α: 0.61-0.90) and good to excellent test-retest reliability (ICC: 0.713-0.935). Conclusions This study is the first to adapt the PedsQL™ 3.0 EoE Module for another language with its validity and reliability in assessing the health-related quality of life among Turkish-speaking teens with EoE and their parents.