Advanced Practice Provider EoE Program (Live/Virtual) | October 2025-EoE for the Advanced Practice Provider Journal Article

EoE for the Advanced Practice Provider Journal Article_Ilche Nonevski and Sarel Myburgh

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Eosinophilic esophagitis (EoE) is a chronic inflammatory condition affecting the esophagus, commonly associated with symptoms like dysphagia, food impaction, and heartburn in adults, and non-specific symptoms such as vomiting and failure to thrive in children. The condition is primarily caused by an immune response to environmental allergens like food. It leads to increased eosinophils in the esophagus, causing long-standing inflammation that can result in fibrosis and a narrowed esophagus.<br /><br />EoE has seen an increase in prevalence worldwide, with a higher incidence in males and the white population, and strong associations with atopic conditions such as asthma and eczema. Diagnosis typically involves upper endoscopy with esophageal biopsies, revealing specific endoscopic features and eosinophilic infiltration.<br /><br />Management of EoE focuses on achieving histologic remission and symptom reduction through dietary changes, medications, and sometimes endoscopic therapy. Dietary management can involve an elemental diet or a 6-food elimination diet, which has shown significant effectiveness. However, these diets can be challenging to maintain without guidance from an experienced dietitian.<br /><br />Pharmacological treatments include proton pump inhibitors, which achieve symptom improvement in a significant number of cases, and topical corticosteroids like fluticasone and budesonide, which promote histologic remission. Recent advancements have introduced biological therapies such as dupilumab for refractory cases.<br /><br />Endoscopic dilation is an option for patients with fibrotic complications to address stricture and improve symptoms. This intervention, however, does not tackle inflammation itself.<br /><br />Overall, advanced practice providers should consider EoE in patients with a history of atopy presenting with related symptoms and utilize a comprehensive, tailored approach to manage this condition effectively.

Keywords

Eosinophilic esophagitis

dysphagia

food impaction

immune response

eosinophils

atopic conditions

endoscopy

dietary management

topical corticosteroids

biological therapies