Diagnosis and treatment of eosinophilic esophagitis

Abstract

Eosinophilic esophagitis is a rare type of esophageal disease that features dense intraepithelial infiltration by eosinophils, which is caused by an allergic reaction to food or aeroallergens. Chronic eosinophil-related inflammation causes edema and fibrosis in the esophageal submucosal layer, while abnormal esophageal motor activity and fibrosis-related esophageal stenosis result in unpleasant symptoms including dysphagia and food impaction. In an endoscopic study of affected patients, longitudinal furrows, whitish stipple-like exudates, and multiple focal strictures were often found. For establishment of the diagnosis, dense infiltration of eosinophils (15-30 eosinophils/HPF) should be identified in an esophageal mucosal biopsy specimen. Local administration of glucocorticoids has recently been reported as useful first-line therapy for eosinophilic esophagitis.