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World J Gastrointest Pathophysiol. Oct 25, 2018; 9(3): 63-72
Published online Oct 25, 2018. doi: 10.4291/wjgp.v9.i3.63
Gastro-oesophageal reflux disease and eosinophilic oesophagitis: What is the relationship?
Stephanie Wong, Andrew Ruszkiewicz, Richard H Holloway, Nam Q Nguyen
Stephanie Wong, Andrew Ruszkiewicz, Richard H Holloway, Nam Q Nguyen, Discipline of Medicine, University of Adelaide, Adelaide SA 5000, Australia
Stephanie Wong, Richard H Holloway, Nam Q Nguyen, Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide SA 5000, Australia
Andrew Ruszkiewicz, Anatomical Pathology, SA Pathology, Adelaide SA 5000, Australia
Author contributions: Wong S contributed to drafting of manuscript; Ruszkiewicz A, Holloway RH and Nguyen NQ contributed to critical revisions of manuscript.
Conflict-of-interest statement: There is no conflict of interest to disclose from all authors.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Nam Q Nguyen, FRACP, MBBS, PhD, Associate Professor, Doctor, Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Port Road, Adelaide SA 5000, Australia. quocnam.nguyen@sa.gov.au
Telephone: +61-70-7442142 Fax: +61-8-7746192
Received: August 2, 2018
Peer-review started: August 3, 2018
First decision: August 24, 2018
Revised: September 17, 2018
Accepted: October 11, 2018
Article in press: October 11, 2018
Published online: October 25, 2018
Processing time: 84 Days and 3 Hours
Abstract

Eosinophilic oesophagitis (EoE) and gastro-oesophageal reflux disease (GORD) are the most common causes of chronic oesophagitis and dysphagia associated with oesophageal mucosal eosinophilia. Distinguishing between the two is imperative but challenging due to overlapping clinical and histological features. A diagnosis of EoE requires clinical, histological and endoscopic correlation whereas a diagnosis of GORD is mainly clinical without the need for other investigations. Both entities may exhibit oesophageal eosinophilia at a similar level making a histological distinction between them difficult. Although the term proton-pump inhibitor responsive oesophageal eosinophilia has recently been retracted from the guidelines, a relationship between EoE and GORD still exists. This relationship is complex as they may coexist, either interacting bidirectionally or are unrelated. This review aims to outline the differences and potential relationship between the two conditions, with specific focus on histology, immunology, pathogenesis and treatment.

Keywords: Relationship; Pathogenesis; Eosinophilic oesophagitis; Histological features; Gastro-oesophageal reflux disease

Core tip: The relationship between gastro-oesophageal reflux disease and eosinophilic oesophagitis is complex as they may coexist, either interacting bidirectionally or are unrelated. This review aims to outline the differences and potential relationship between the two conditions, with specific focus on histology, immunology, pathogenesis and treatment.