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World J Gastrointest Pathophysiol. Sep 22, 2026; 17(3): 121571
Published online Sep 22, 2026. doi: 10.4291/wjgp.121571
Published online Sep 22, 2026. doi: 10.4291/wjgp.121571
Advancing the understanding of eosinophilic esophagitis: From pathogenesis to novel therapies
Ashish Sharma, Department of Hospital Medicine, Yale New Haven Hospital, New Haven, CT 06510, United States
Angad Tiwari, Department of Internal Medicine, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh 284001, India
Vishal Deshpande, Department of Internal Medicine, ESIC Medical College, Gulbarga, Karnataka 585106, India
Vishal Abhimutt Mahesh, Department of Internal Medicine, Government Medical College and Hospital, Chandigarh 160030, India
Harendra Kumar, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, United States
Anuj Shah, Department of Public Health, Yale School of Public Health, Yale University, New Haven, CT 06510, United States
Ishita Ray, Rajvardhan Sisodia, Department of Internal Medicine, Mahatma Gandhi Memorial Medical College, Indore 452001, Madhya Pradesh, India
Sneh Sonaiya, Department of Internal Medicine, University of Nevada, Las Vegas, NV 89154, United States
Saqr Alsakarneh, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, United States
Hassam Ali, Department of Gastroenterology, Hepatology and Nutrition, East Carolina University, Brody School of Medicine, Greenville, NC 27858, United States
Dushyant Singh Dahiya, Division of Gastroenterology, Hepatology and Motility, University of Kansas School of Medicine, Kansas City, KS 66160, United States
Author contributions: Sharma A, Tiwari A, Deshpande V, Mahesh VA, Kumar H, Shah A, Ray I, Sisodia R, Sonaiya S, Alsakarneh S, Ali H, Dahiya DS contributed to literature review and manuscript drafting; Sharma A, Tiwari A, Deshpande V, and Dahiya DS supervised manuscript development; Sharma A, Tiwari A, Deshpande V, Alsakarneh S, Ali H and Dahiya DS critically revised the manuscript; Sharma A, Tiwari A, Ali H, and Dahiya DS conceptualized the review and designed the manuscript. All authors approval the final manuscript.
AI contribution statement: Grammarly was used for grammatical correction and language polishing throughout the manuscript. A large language model (Claude, Anthropic) was used to assist with editorial reformatting (removal of heading numbering per journal requirements, standardization of non-standard Unicode punctuation), consolidation and renumbering of the reference list. The scientific content of the manuscript - including study scope, literature interpretation, mechanistic explanations, comparative analysis of international guidelines, and all clinical conclusions - was conceived and written by the authors based on their clinical and academic expertise. No AI tool participated in the design of the review or the interpretation of evidence. The authors take full responsibility for the integrity and accuracy of the entire manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Dushyant Singh Dahiya, MD, Division of Gastroenterology, Hepatology and Motility, University of Kansas School of Medicine, 2000 Olathe Boulevard, Kansas City, KS 66160, United States. dush.dahiya@gmail.com
Received: March 27, 2026
Revised: June 1, 2026
Accepted: June 17, 2026
Published online: September 22, 2026
Processing time: 165 Days and 4.9 Hours
Revised: June 1, 2026
Accepted: June 17, 2026
Published online: September 22, 2026
Processing time: 165 Days and 4.9 Hours
Core Tip
Core Tip: Eosinophilic esophagitis is increasingly recognized as a progressive fibrostenotic disease in which symptom severity may not correlate with histologic activity, contributing to diagnostic delays and long-term esophageal remodeling. New imaging modalities including functional luminal imaging probe, Cytosponge, and artificial intelligence driven histologic scoring have shown promise in assessing disease beyond eosinophilic counts. Precision medicine approaches and endotype driven therapies are expected to transform patient management in the near future.