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World J Gastrointest Pharmacol Ther. May 6, 2016; 7(2): 207-213
Published online May 6, 2016. doi: 10.4292/wjgpt.v7.i2.207
Eosinophilic esophagitis in adults: An update
Monjur Ahmed
Monjur Ahmed, Division of Gastroenterolgy and Hepatology, Department of Internal Medicine, Thomas Jefferson University, Philadelphia, PA 19107, United States
Author contributions: Ahmed M solely contributed to this work.
Conflict-of-interest statement: None to declare.
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: Monjur Ahmed, MD, FRCP, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Thomas Jefferson University, 132 South 10th Street, Suite 480, Main Building, Philadelphia, PA 19107, United States. monjur.ahmed@jefferson.edu
Telephone: +1-215-9521493 Fax: +1-215-7551850
Received: November 9, 2015
Peer-review started: November 9, 2015
First decision: December 18, 2015
Revised: January 10, 2016
Accepted: March 14, 2016
Article in press: March 16, 2016
Published online: May 6, 2016
Processing time: 163 Days and 15.7 Hours
Abstract

Eosinophilic esophagitis is a worldwide chronic allergic disease of the esophagus. In the last decade, there is an epidemic of this entity in the western world. Mostly seen in children and young adults, patients present with dysphagia or food impaction in the emergency room. Characteristic endoscopic findings, esophageal eosinophilia and non-responsiveness to proton pump inhibitors help make the diagnosis. Avoidance of food allergens, administration of steroidal anti-inflammatory medications and dilation of the esophagus are the mainstays of treatment. Investigations are ongoing for mucosal healing and optimum maintenance treatment.

Keywords: Eosinophilic esophagitis; Dysphagia; Food bolus impaction; Esophageal eosinophilia; Esophageal stricture

Core tip: While eosinophilic esophagitis is an important differential diagnosis in the field of dysphagia and acute food bolus impaction, the understanding and management of this disease is still in its infancy. It is now considered as the second most common cause of chronic esophagitis. This article focuses on the diagnostic criteria, epidemiology, pathogenesis, pathology, clinical presentation, investigations including endoscopic reference score, current treatment options and future potential agents.