Diagnosing and Managing Eosinophilic Esophagitis

Background

Eosinophilic esophagitis (EoE) is a chronic immune-mediated disorder of the esophagus in which eosinophilic inflammation leads to esophageal dysfunction. Young children present with feeding difficulties, vomiting, and abdominal pain, whereas older children and adults develop dysphagia and food impaction. Most patients with EoE also have other atopic disorders.

Key Points

• EOE is diagnosed with an endoscopic biopsy that shows ≥15 eosinophils per high-power field in a patient with symptoms of esophageal dysfunction.

• High-dose proton-pump inhibitors are effective in about half of patients, regardless of the presence or absence of reflux disease.

• Swallowed topical steroids (off-l…