EoE ToT Module 2 References-Dellon et al Gastroenterology 2018 SUPPL NIHMS896779-supplement-supplement

Dellon et al Gastroenterology 2018 SUPPL NIHMS896779-supplement-supplement_1

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Eosinophilic Esophagitis (EoE) is an allergen/immune-mediated disease characterized by symptoms of esophageal dysfunction and eosinophilic infiltration. First reported in the late 1970s, EoE has transformed into a notable condition commonly encountered in clinical settings. Over the past two decades, its incidence and prevalence have rapidly increased, outpacing disease recognition rates, suggesting environmental influences over genetic ones. Current incidence estimates range from 5 to 10 cases per 100,000 people annually, with prevalence ranging from 0.5 to 1 case per 1000.<br /><br />EoE affects both children and adults, with a higher prevalence in Western countries compared to Asia. Geographic variations highlight the importance of focusing on environmental factors to understand the disease better. The prevalence is notably higher in special populations, such as individuals undergoing endoscopy for dysphagia or food bolus impaction.<br /><br />Several risk factors are believed to contribute to EoE, including food and environmental allergens, early-life exposures like antibiotics, Cesarean delivery, and infections (e.g., Helicobacter pylori), which show an inverse association with EoE. Specific genetic conditions like connective tissue disorders are also linked to higher EoE incidence.<br /><br />The natural history of EoE involves progression from an inflammatory to a fibrostenotic phenotype, often resulting in chronic inflammation and esophageal remodeling. Studies indicate that untreated EoE significantly increases the risk of developing strictures over time. The duration of untreated disease is the best predictor for the formation of such strictures. Prospective long-term studies are necessary to understand better the full spectrum of disease progression and the impact of various treatments.<br /><br />The emergence and rising incidence of EoE underscore the need for continued research into its etiology and natural history. Understanding environmental and genetic factors and patient management strategies are crucial for effectively treating and potentially preventing this chronic condition. Prospective long-term outcome studies are essential for gaining deeper insights into EoE's progression and effective management strategies.

Keywords

Eosinophilic Esophagitis

EoE

esophageal dysfunction

eosinophilic infiltration

environmental factors

genetic conditions

chronic inflammation

disease progression

prevalence

risk factors