EoE Module 14 References-Gonsalves et al J Allergy Clin Immunol 2020 Diagnosis and treatment of eosinophilic esophagitis

Gonsalves et al J Allergy Clin Immunol 2020 Diagnosis and treatment of eosinophilic esophagitis

Pdf Summary

Eosinophilic esophagitis (EoE) is a chronic immune-mediated disorder characterized by symptoms related to esophageal dysfunction due to eosinophil-rich inflammation. The condition requires a diagnostic presence of at least 15 eosinophils per high-power field in esophageal tissue samples. Typical symptoms include heartburn, regurgitation, vomiting, dysphagia, food impaction, and abdominal pain. Without treatment, EoE leads to esophageal remodeling and strictures necessitating long-term maintenance therapy to prevent progression and complications.<br /><br />The diagnosis of EoE involves identifying characteristic endoscopic features like linear furrows and mucosal rings, combined with histological evidence from esophageal biopsies. New non-invasive diagnostic tools are under development to potentially reduce reliance on traditional endoscopy.<br /><br />Treatment options for EoE include dietary modifications, medications, and esophageal dilation. Empiric elimination diets, such as removing specific food groups suspected to trigger EoE, are a first-line approach despite challenges related to adherence and the need for multiple endoscopies. Medical therapies majorly consist of proton pump inhibitors (PPIs) and topical corticosteroids (TCS), which reduce inflammation and improve symptoms but need long-term administration to counter disease recurrence.<br /><br />Esophageal dilation is used primarily for treating strictures. Research efforts are ongoing to better identify food allergens that trigger EoE and to develop non-invasive diagnostic assessments for long-term disease management. There remains a quest for identifying markers that can predict therapy response and disease progression. The chronic nature of EoE and its potential for significant esophageal damage highlight the importance of sustained therapy and monitoring to manage inflammation effectively and improve patients' quality of life.

Keywords

Eosinophilic esophagitis

chronic disorder

esophageal dysfunction

eosinophil-rich inflammation

diagnostic criteria

endoscopic features

dietary modifications

proton pump inhibitors

topical corticosteroids

esophageal dilation