EoE Module 13 References-Woo et al Curr Opin Gastroenterol 2021 The role of the allergist in the management of EoE

Woo et al Curr Opin Gastroenterol 2021 The role of the allergist in the management of EoE

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The article explores the role of allergists in managing Eosinophilic Esophagitis (EoE), a chronic T2 immune disorder often associated with other allergic diseases. EoE is characterized by esophageal dysfunction symptoms and histological features like eosinophils in the esophagus. It commonly coexists with other atopic conditions such as asthma, allergic rhinitis, and eczema. The pathogenesis of EoE involves an interplay of food and aeroallergens, the T2 immune response, and genetic predispositions. EoE is triggered primarily by food allergies, though aeroallergens can also play a role.<br /><br />The management of EoE requires allergists to identify and control triggering allergens and underlying atopic disorders. This involves allergy testing to assess both food and environmental allergen sensitivities, essential for developing effective management plans. Food allergens, although not always IgE-mediated, can significantly impact EoE, and dietary interventions can serve as both diagnostic and therapeutic tools. However, while common tests like skin prick tests and specific IgE assessments help manage immediate food allergies, they do not consistently predict food triggers in EoE.<br /><br />A multidisciplinary approach involving gastroenterologists, allergists, and other specialists is recommended for optimal patient care. This is due to the complexities of EoE as a condition related to other atopic diseases, necessitating thorough assessment and management. The review emphasizes the importance of allergists' expertise in evaluating atopy and guiding interventions such as dietary modifications and advising on allergen avoidance. Additionally, ongoing research into novel therapies and diagnostic tools, including biologics, holds the potential to enhance EoE management. Overall, this collaborative, specialized approach is vital for effectively tackling the nuances of EoE in patients with multiple concurrent allergic conditions.

Keywords

Eosinophilic Esophagitis

allergists

T2 immune disorder

esophageal dysfunction

atopic conditions

food allergies

aeroallergens

allergy testing

dietary interventions

multidisciplinary approach