Eosinophilic Esophagitis

This chapter discusses the background, diagnosis, treatment, and prognosis for eosinophilic esophagitis (EoE). EoE is a chronic, immune/antigen-mediated esophageal disease characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil-predominant inflammation. Although it is a relatively newly recognized disease, EoE has been reported worldwide, and its prevalence has been increasing over time. EoE seems to be triggered by multiple foods, and possibly aeroallergens. The pathogenesis of EoE is poorly understood and histopathology points towards an allergic phenomenon. Children typically present with abdominal pain, gastroesophageal reflux symptoms, vomiting, feeding difficulties, and, at times, failure to thrive. Older children and adults present with dysphagia and esophageal food impactions. If left untreated, EoE may lead to complications such as esophageal narrowing and strictures. Treatment has so far consisted of various forms of dietary restrictions and/or topical corticosteroids to the esophagus with variable success.