EoE ToT Module 2 References-Dellon et al Gastroenterology 2019 Epidemiology and natural history of eosinophilic esophagitis PUBMED

Dellon et al Gastroenterology 2019 Epidemiology and natural history of eosinophilic esophagitis PUBMED

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Eosinophilic esophagitis (EoE) has evolved markedly over the past two decades, transitioning from a rare condition to a common cause of upper gastrointestinal issues. The incidence and prevalence of EoE have increased notably, surpassing the rate of improved diagnostics and awareness. Current estimates place its incidence at 5-10 cases per 100,000 per year and the prevalence at 0.5-1 per 1,000 individuals. Potential causes include environmental changes and reduced Helicobacter pylori infections, as genetic predispositions appear less influential.<br /><br />EoE is characterized by an eosinophil infiltration in the esophageal mucosa, prompted by allergens, without secondary causes. This infiltration progresses from inflammation to a fibrostenotic (scarring) phenotype if untreated, which can lead to esophageal strictures. The natural history of EoE shows that untreated disease duration is the best predictor of stricture risk, emphasizing the need for early diagnosis and treatment.<br /><br />Studies from North America and Europe reveal significant variation in EoE incidence and prevalence by geography, with higher rates in Western countries compared to Eastern regions like China and Japan. The disease is diagnosed more frequently in rural areas with lower population densities, hinting at environmental factors such as aeroallergens influencing its development. Additionally, early-life factors like antibiotic use, cesarean section, and preterm delivery are linked to increased EoE risk.<br /><br />Management involves dietary modifications and medical therapies to reduce inflammation and progression. Elimination diets and hypoallergenic formulas can induce remission. Long-term treatments and adherence are crucial to mitigate the development of fibrostenotic complications. Prospective studies underscore the chronicity of EoE and the necessity for ongoing management strategies to prevent esophageal remodeling and its consequences.<br /><br />In summary, EoE's emergence as a significant clinical issue calls for continued research into its causes, early-life influences, and long-term management to improve patient outcomes and address the growing healthcare burden.

Keywords

Eosinophilic esophagitis

EoE

gastrointestinal issues

incidence

prevalence

environmental factors

allergens

esophageal strictures

dietary modifications

chronic disease management