Advanced Practice Provider EoE Program (Live/Virtual) | October 2025-Is it EoE Recognizing the Signs

Is it EoE Recognizing the Signs

Pdf Summary

This document provides an overview of Gastroesophageal Reflux Disease (GERD) and Eosinophilic Esophagitis (EoE), focusing on diagnosis, symptom recognition, differentiation, and treatment strategies.<br /><br />GERD commonly presents with heartburn, acid regurgitation, chest pain, dysphagia, and extraesophageal symptoms such as cough and hoarseness. Its etiology includes lower esophageal sphincter dysfunction leading to acid reflux, with complications like peptic strictures, Barrett’s esophagus, and esophageal adenocarcinoma. Diagnostic tools include endoscopy, pH monitoring (Bravo system, ambulatory pH/impedance), and barium studies. Management prioritizes proton pump inhibitors (PPIs) as first-line therapy, lifestyle modifications, and surgery (fundoplication) in selected patients with typical symptoms and PPI-resistant disease. Long-term PPI use warrants careful dose management and monitoring for side effects.<br /><br />EoE is a chronic immune-mediated esophageal disorder characterized by eosinophilic infiltration (>15 eosinophils/hpf) triggered by food antigens, commonly causing dysphagia and food impaction, mainly in young adults. Diagnosis involves endoscopy with biopsy and can be complemented by barium esophagram to detect esophageal rings, strictures, or diffuse narrowing not always visualized on endoscopy. Treatments include high-dose PPIs, topical steroids (budesonide, fluticasone), dietary elimination, and in refractory cases, biologics like dupilumab. Esophageal dilation may be needed for strictures.<br /><br />Differentiating GERD and EoE relies on symptom patterns (heartburn/regurgitation vs. dysphagia/food impaction), endoscopic findings (reflux esophagitis vs. rings, furrows, edema in EoE), histology, and response to therapy. The document also outlines other esophageal disorders causing dysphagia, such as Zenker's diverticulum, achalasia (loss of esophageal peristalsis and LES relaxation), and scleroderma-associated motility issues.<br /><br />Clinical vignettes emphasize evidence-based management approaches for GERD and highlight the need for repeat endoscopy after high-grade esophagitis treatment. Extraesophageal GERD symptoms require careful evaluation, often including reflux monitoring before therapy.<br /><br />In summary, accurate recognition and differentiation of GERD and EoE are critical, utilizing appropriate diagnostic tools and tailored therapies to optimize patient outcomes.

Keywords

Gastroesophageal Reflux Disease

GERD

Eosinophilic Esophagitis

EoE

diagnosis

symptoms

treatment

proton pump inhibitors

endoscopy

esophageal disorders