Eosinophilic esophagitis

Abstract

Eosinophilic esophagitis (EoE) is a relatively recently recognized, esophageal disorder with symptoms that are dominated in adults by dysphagia. Based on a 2011 consensus recommendation by a working group of adult and pediatric gastroenterologists, allergists, and pathologists, EoE has been conceptually defined as a chronic, immune/antigen-mediated disease characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil-predominant inflammation [1]. Once viewed as an esoteric diagnosis, EoE has emerged over the past two decades as an important consideration in the evaluation of abnormal deglutition and foregut symptoms in both children and adults. Studies over the past few years have demonstrated that EoE is now a leading cause of esophageal dysphagia amongst adult patients, second only to gastroesophageal reflux disease (GERD). The disease has significant impact on patients quality of life and important complications of esophageal strictures, food impaction, and esophageal perforation. The pathogenesis of EoE involves both environmental and genetic factors with evidence supporting a primary role for food antigens inciting the inflammatory response. Medical therapy with topical corticosteroids, dietary therapies incorporating elimination of specific food antigens and esophageal dilation are highly effective.