Abstract
The incidence and recognition of eosinophilic esophagitis is increasing. Pathophysiological understanding of eosinophilic esophagitis is improving and an immunological reaction to ingested food is likely to play a significant role. Patients present with dysphagia and food bolus obstruction. Both histological and endoscopic criteria have been developed and validated. Dietary therapy, topical steroid therapy, proton pump inhibitors and endoscopic dilation are the main approaches to therapy; however, novel targeted therapies are being developed. Among the food items commonly implicated are wheat, dairy, nuts, soy, shellfish and eggs. A multidisciplinary approach to management in dedicated clinics may yield the best results.
Highlights
The incidence and recognition of eosinophilic esophagitis is increasing
DEFINITION AND EPIDEMIOLOGY Eosinophilic esophagitis (EoE) is a comparatively recent newcomer to the field of gastroenterology, with the first case described in literature by Landres et al [1] in 1978
Several studies have shown that typical endoscopic features, when combined with clinical symptoms, other risk factors, such as an atopic history, can often discriminate EoE from mimics such as reflux esophagitis [27,28]
Summary
The incidence and recognition of eosinophilic esophagitis is increasing. Pathophysiological understanding of eosinophilic esophagitis is improving and an immunological reaction to ingested food is likely to play a significant role. Its recognition as a clinically relevant and potentially manageable disorder has increased, first in pediatric and, more recently, in adult gastroenterology. EoE in adults is defined clinically by symptoms of esophageal dysfunction including dysphagia, reflux and food impaction [2,3].
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