Eosinophilic oesophagitis

Abstract

Eosinophilic oesophagitis is a chronic immune/antigen-mediated disease defined by eosinophilic inflammation of the oesophagus and by symptoms of oesophageal dysfunction. The disease is sometimes referred to as ‘asthma of the oesophagus’ because of its similar clinical and pathological characteristics to asthma. It is currently the most prevalent cause of oesophagitis after gastro-oesophageal reflux disease. The aetiology of eosinophilic oesophagitis is multifactorial and includes environmental triggers, early-life influences and genetic predisposition. This is a complex condition and the pathogenesis is still not completely clear. Presentation varies according to age, evolving from non-specific symptoms in the very young population to more specific oesophageal symptoms such as dysphagia in the older age group. Clinical suspicion should always be followed by upper gastrointestinal endoscopy and biopsies confirming oesophageal eosinophilia. Multidisciplinary management is key and should include paediatricians, gastroenterologists, dietitians, allergists and pathologists. With this article I aim to raise awareness of this condition in order to encourage earlier recognition and treatment.