PPI-Responsive Esophageal Eosinophilia: Is It Reflux Disease in Disguise?

PPI-REE shows more GERD-like qualities compared with EoE.

National guidelines recommend that clinicians rule out proton-pump inhibitor (PPI)-responsive esophageal eosinophilia (PPI-REE) before diagnosing eosinophilic esophagitis (EoE; NEJM JW Gastroenterol Aug 2013 and Am J Gastroenterol 2013; 108:679). The pathophysiologic connection between the two conditions, however, is still unclear.

To compare symptoms and high-resolution manometry features of EoE, PPI-REE, and gastroesophageal reflux disease (GERD), researchers prospectively evaluated 35 patients with EoE, 17 with PPI-REE (identified after 8 weeks of twice-daily PPI), and 27 with GERD with erosive esophagitis (Los Angeles grade) with or without abnormal esophageal pH. Validated symptom assessment (GerdQ questionnaire) was conducted by invest…

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors