Eosinophilic Esophagitis-What Do We Know So Far?

Eosinophilic esophagitis is a Th-2 antigen-mediated disease in which there is an influx of eosinophils to all layers of the esophagus, triggering an inflammatory response. Chronic inflammatory process causes esophageal remodeling, leading to difficulties in swallowing. Food impaction, heartburn, and chest pain are other characteristic (but not pathognomonic) symptoms in adults. Although the disease has only been described since in the early 1970s, its incidence and prevalence are rapidly growing, especially in Western countries. According to the diagnostic guidelines, there should be at least 15 eosinophils visible per high-power field in biopsies obtained from different sites in the esophagus upon endoscopy with relevant esophageal symptoms. Other diseases that can cause esophageal eosinophilia should be ruled out. Eosinophilic esophagitis treatment may be challenging; however, new methods of management have recently emerged. The currently used proton pump inhibitors, topical corticosteroids, and elimination diet are combined with biological treatment. New methods for disease diagnostics and clinical course assessment are also available. This review presents current knowledge about the disease, supported by the latest research data.

Automated summary

Eosinophilic esophagitis is a Th-2 antigen-mediated disease that causes inflammation in the esophagus with an influx of eosinophils. It leads to esophageal remodeling and difficulties in swallowing. While the disease has a relatively short history, its incidenc e and prevalence are increasing rapidly, especially in Western countries. The diagnosis requires the presence of at least 15 eosinophils per high-power field in esophageal biopsies, along with relevant symptoms and exclusion of other causes of esophageal eosinophilia. Treatment options for eosinophilic esophagitis are challenging, but the combination of proton pump inhibitors, topical corticosteroids, elimination diet, and biological treatment has shown promise. New methods for disease diagnosis and clinical assessment are also available.