Eosinophilic oesophagitis – a common disease, newly recognised

Abstract

Eosinophilic oesophagitis is a clinico-pathologic diagnosis that describes patients with dysphagia (intermittent or continuous), food bolus obstruction or regurgitation, where endoscopy and biopsy reveals high concentrations of eosinophils in the lining of the oesophagus. At endoscopy, the presence of rings (trachealisation), furrows, micro-abscesses and strictures may be noted, but sometimes the appearance is normal. Hence biopsy is essential in every patient with dysphagia. The condition, recognised 25 years ago as a separate disease entity, not related to gastro-oesophageal reflux, is now becoming common. It is important for all general physicians to recognise this and make an accurate diagnosis in order to give specific treatment. This may involve topical steroids, leukotreine D4 antagonists, dietary exclusions and dilatations.