Advanced Practice Provider EoE Program (Live/Virtual) | November 2024-EoE for the Advanced Practice Provider Journal Article

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Eosinophilic esophagitis (EoE) is a chronic inflammatory disorder that affects the esophagus, commonly seen in both children and adults. Initially described in the 1970s, it manifests through symptoms like dysphagia, food impaction, chest pain, and persistent heartburn in adults, while children often experience vomiting, abdominal pain, and growth issues. EoE arises from the interplay between environmental allergens and the immune system, leading to an accumulation of eosinophils in the esophagus, causing long-term inflammation and potential fibrosis. <br /><br />The incidence and prevalence of EoE have increased globally, with higher occurrences in males, particularly among those with a history of atopic diseases like asthma and eczema. A significant 2016 US study noted a higher prevalence in white individuals, with most diagnoses occurring in the 18 to 65 age range. <br /><br />Diagnosis of EoE involves an upper endoscopy with biopsy, identifying at least 15 eosinophils per high-power field, after excluding other conditions. EoE's symptoms often overlap with gastroesophageal reflux disease (GERD), complicating diagnosis.<br /><br />Treatment focuses on achieving symptom relief and histologic remission. Options include dietary elimination of common allergens, proton pump inhibitors (PPIs), and topical corticosteroids, with dupilumab as an option for more refractory cases. Endoscopic dilation can help alleviate symptoms caused by esophageal narrowing due to fibrosis.<br /><br />Advanced practice providers should recognize EoE, especially in patients with atopic disease history and esophageal symptoms, and consider appropriate management strategies involving dietary changes and medication to prevent long-term complications. Elimination diets should be guided by dietitians, and dilation should be a supplementary treatment for structure-related symptoms.

Asset Subtitle

Ilche T. Nonevski, MD, MBA, Sarel J. Myburgh, APRN, CNP, MS

Keywords

Eosinophilic esophagitis

chronic inflammatory disorder

dysphagia

food impaction

environmental allergens

immune system

biopsy

proton pump inhibitors

dietary elimination

endoscopic dilation