Chronic immune-mediated/allergen-mediated condition defined clinically by symptoms of esophageal dysfunction, and pathologically by an eosinophilic infiltration of the esophageal epithelium in the absence of secondary causes of local or systemic eosinophilia.
To consider the diagnosis, there must be an esophageal epithelial infiltrate of ≥15 eosinophils per high-power microscopy field on esophageal biopsy.
Incidence and prevalence are increasing at a rate that is outpacing increased recognition and diagnosis; it is more commonly seen in children and young adults.
Medications (usually topical/swallowed corticosteroids) or dietary elimination can be used as a first-line treatment, with endoscopic dilation reserved for patients with esophageal strictures or fibrostenotic complications.
Prognosis is good, with the majority of patients having a good response to either pharmacologic or dietary elimination therapy.
Eosinophilic esophagitis (EoE) is a chronic, immune-mediated/allergen-mediated clinicopathologic condition. It is characterized clinically by symptoms of esophageal dysfunction (e.g., dysphagia and food impaction in adolescents and adults, and vomiting, regurgitation, heartburn, abdominal pain, failure to thrive, or feeding intolerance in children), and histologically by an eosinophilic infiltration of the esophageal epithelium of ≥15 eosinophils per high-power microscopy field in the absence of other causes of local or systemic eosinophilia.
History and exam
Consultant Paediatric Gastroenterologist
Chelsea and Westminster Hospital
JE is a member of the advisory board for Dr Falk, who make Jorveza, a new formulation of budesonide licensed for adults with eosinophilic esophagitis (EoE). She has received honoraria from Dr Falk to speak on EoE and been sponsored by Dr Falk to attend an academic meeting on EoE in Vienna in 2018.
Dr Jenny Epstein wishes to gratefully acknowledge Dr Evan S. Dellon, the previous contributor to this topic.
Professor of Medicine
DK has served on advisory boards (Adare, Receptos) and received research funding (Covidien).
Chief of the Division of Gastroenterology and Hepatology
First Department of Pediatrics
University of Athens
Agia Sofia Children’s Hospital
AP has received speaker’s honorariums from Nestle and Nutricia; research grants from Biogaia/Nutricia/Abbvie; consultant’s fee from Receptos.
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