Eosinophilic Esophagitis

Abstract

Eosinophilic esophagitis (EoE) is a chronic immune condition affecting children and adults. Dysphagia and food impaction are the main symptoms; however, reflux-like symptoms may also be present. The diagnosis of EoE is made with endoscopic evaluation for dysphagia, and its definitive diagnosis requires biopsy confirmation. The criteria for active EoE are defined as the symptoms of esophageal dysfunction, eosinophilic tissue infiltration (eosinophil count of at least 15 eosinophils per high-power field), and exclusion of other possible causes of esophageal eosinophilia. EoE is more prevalent in patients suffering from atopic conditions; therefore, allergic conditions may play an important role in the development of the disease. However, the etiology and pathophysiology of the disease are not completely understood. Elimination diets are considered as the first-line therapy in children; nevertheless, this approach appears to be less effective in adults, who often require steroids. Despite medical treatments, EoE is complicated in some cases by esophageal stricture and stenosis that require additional endoscopic treatments.