Eosinophilic Esophagitis: Incidence, Diagnosis, Management, and Future Directions

Gastroenterol Clin North Am. 2021 Dec;50(4):825-841. doi: 10.1016/j.gtc.2021.08.001. Epub 2021 Oct 6.

Abstract

Eosinophilic esophagitis (EoE) is an antigen-mediated esophageal disease defined by the presence of esophageal eosinophilia and symptoms of esophageal dysfunction. The pathophysiology involves an allergen-driven Th2 T cell response that triggers infiltration of eosinophils into the esophagus leading to inflammation, remodeling, and fibrosis. This results in disruption of esophageal function and accompanying symptoms - most notably dysphagia. Effective therapies target inflammation or fibrostenotic complications and include proton pump inhibitors, swallowed topical steroids, dietary exclusion, and dilation. Clinical trials testing promising biologic therapies are ongoing.

Keywords: Elimination diets; Eosinophilic esophagitis; Proton pump inhibitors; Swallowed topical steroids.

Publication types

  • Review

MeSH terms

  • Enteritis*
  • Eosinophilic Esophagitis* / diagnosis
  • Eosinophilic Esophagitis* / epidemiology
  • Eosinophilic Esophagitis* / therapy
  • Gastritis*
  • Humans
  • Incidence
  • Proton Pump Inhibitors / therapeutic use

Substances

  • Proton Pump Inhibitors