Eosinophilic esophagitis: Update and review

Abstract

Eosinophilic esophagitis (EoE) is a chronic immune-mediated clinicopathological condition characterized by symptoms of esophageal dysfunction (dysphagia and food impaction) along with esophageal biopsies showing an eosinophilic infiltrate in the mucosa of 15 or more eosinophils per 0.3 mm3 field, excluding other causes of esophageal eosinophilia. Its prevalence has tripled in the last 10 years. This increase cannot solely be attributed to the rise in gastroscopies performed or greater awareness of the disease among health professionals. It is more common in men, particularly in Western countries, and can be associated with other allergic diseases such as asthma, allergic rhinitis, or atopic dermatitis. Diagnosis is based on the histological examination of esophageal biopsies. Various treatments are available, including proton pump inhibitors, corticosteroids, empiric exclusion diets, or biological drugs. Disease progression can lead to esophageal fibrosis and strictures that may necessitate treatment with endoscopic dilation.