EoE ToT Module 2 References-Dellon et al Gastroenterology 2018 Epidemiology and natural history of eosinophilic esophagitis

Dellon et al Gastroenterology 2018 Epidemiology and natural history of eosinophilic esophagitis

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Eosinophilic esophagitis (EoE) is an immune-mediated esophageal condition caused by allergens. It has seen a significant rise from a rare disease to a common gastrointestinal issue over the past two decades. EoE presents with esophageal dysfunction symptoms and increased eosinophils in the esophageal mucosa. Estimates suggest an incidence rate of 5-10 per 100,000 and a prevalence of 0.5-1 per 1,000. The condition often progresses from inflammation to fibrous narrowing (fibrostenosis), making early detection and treatment crucial to avoid long-term complications like esophageal strictures.<br /><br />Risk factors for EoE include allergic reactions to food and environmental triggers, early-life exposures, and certain infections like Helicobacter pylori, which has an inverse relationship with EoE. The rapid increase in EoE incidence points to environmental rather than genetic causes. Studies highlight that untreated EoE usually persists, leading to chronic symptoms and esophageal narrowing over time. Endoscopically, inflammation can progress to fibrosis, increasing the risk of strictures if not managed appropriately.<br /><br />Key management strategies for EoE include dietary modifications to eliminate allergens, medical therapies like proton pump inhibitors (PPIs), and topical steroids. Prospective studies are needed to understand the disease’s long-term natural history, etiology, and to identify effective interventions to slow its progression.<br /><br />Geographic prevalence variations have been observed, with higher rates in Western countries and lower in Eastern countries, suggesting different environmental exposures or diagnostic awareness levels. Future research must focus on the mechanisms behind EoE development and progression, to improve patient outcomes and management strategies.

Keywords

Eosinophilic esophagitis

immune-mediated

allergens

esophageal dysfunction

fibrostenosis

risk factors

dietary modifications

proton pump inhibitors

topical steroids

geographic prevalence