EoE Module 7 References-Read et al J Neurogastroenterol Motil 2012 Biomechanics of esophageal function in eosinophilic esophagitis

Read et al J Neurogastroenterol Motil 2012 Biomechanics of esophageal function in eosinophilic esophagitis

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"Eosinophilic esophagitis (EoE) is a chronic inflammatory condition of the esophagus characterized by eosinophilic infiltration leading to symptoms such as dysphagia, chest pain, and food impaction. The diagnosis of EoE involves clinical symptoms and specific histopathological criteria, including the presence of at least 15 eosinophils per high-power field in biopsy samples. While traditionally pathogenesis is linked to immune reactions against food or environmental antigens, recent studies have focused on the biomechanical dysfunctions of the esophagus caused by EoE.<br /><br />Various diagnostic tools like manometry, impedance planimetry, barium esophagograms, and endoscopic ultrasound have been employed to study the esophageal function in EoE, revealing multiple functional abnormalities. These include decreased esophageal compliance and distensibility, luminal narrowing, and dysfunctional esophageal muscle responses. Despite normal endoscopic appearances, patients may experience mechanical obstructions due to fibrotic changes. Methods like high-resolution impedance planimetry have noted a decrease in esophageal distensibility, which correlates poorly with eosinophil count, suggesting structural changes independent of eosinophilic concentration.<br /><br />Treatment strategies include dietary modifications, immunosuppressive medications, and dilation procedures. The main aim of these therapies is to reduce inflammation while addressing mechanical dysfunction. Despite their utility, the impact of these interventions on the mechanical properties of the esophagus remains under-researched.<br /><br />As EoE incidence continues to rise, studies into its biomechanics are crucial to improve diagnosis, management, and treatment outcomes. Future research will benefit from considering both the mechanical and inflammatory aspects of EoE, paralleling approaches used for Crohn's disease, to address the full spectrum of EoE pathophysiology."

Keywords

Eosinophilic esophagitis

chronic inflammatory condition

dysphagia

biomechanical dysfunctions

diagnostic tools

esophageal compliance

dietary modifications

immunosuppressive medications

mechanical obstructions

pathophysiology