Eosinophilic esophagitis in adults: An update

Abstract

Eosinophilic esophagitis is a worldwide chronic allergic disease of the esophagus. In the last decade, there is an epidemic of this entity in the western world. Mostly seen in children and young adults, patients present with dysphagia or food impaction in the emergency room. Characteristic endoscopic findings, esophageal eosinophilia and non-responsiveness to proton pump inhibitors help make the diagnosis. Avoidance of food allergens, administration of steroidal anti-inflammatory medications and dilation of the esophagus are the mainstays of treatment. Investigations are ongoing for mucosal healing and optimum maintenance treatment.

Keywords: Eosinophilic esophagitis, Dysphagia, Food bolus impaction, Esophageal eosinophilia, Esophageal stricture

Core tip: While eosinophilic esophagitis is an important differential diagnosis in the field of dysphagia and acute food bolus impaction, the understanding and management of this disease is still in its infancy. It is now considered as the second most common cause of chronic esophagitis. This article focuses on the diagnostic criteria, epidemiology, pathogenesis, pathology, clinical presentation, investigations including endoscopic reference score, current treatment options and future potential agents.