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World J Methodol. Jun 20, 2023; 13(3): 59-66
Published online Jun 20, 2023. doi: 10.5662/wjm.v13.i3.59
Adult eosinophilic esophagitis and advances in its treatment
Martina Grando, Silvia De Pauli, Giovanni Miotti, Massimiliano Balbi, Marco Zeppieri
Martina Grando, Massimiliano Balbi, Department of Internal Medicine, Azienda Sanitaria Friuli Occidentale, San Vito al Tagliamento 33078, Italy
Silvia De Pauli, Department of Internal Medicine, Azienda Sanitaria Friuli Occidentale, Pordenone 33170, Italy
Giovanni Miotti, Department of Plastic Surgery, University Hospital of Udine, Udine 33100, Italy
Marco Zeppieri, Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
Author contributions: Grando M, De Pauli S, and Zeppieri M wrote the outline and did the research and writing of the manuscript; Grando M, De Pauli S, Miotti G, Balbi M, and Zeppieri M assisted in the writing of the paper; Zeppieri M (a native English speaker, MD, PhD) was responsible for the conception and design of the study and completed the English and scientific editing; Grando M, De Pauli S, and Zeppieri M assisted in the editing and making critical revisions of the manuscript; and all authors provided the final approval of the article.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marco Zeppieri, BSc, MD, PhD, Doctor, Department of Ophthalmology, University Hospital of Udine, p.le S. Maria della Misericordia 15, Udine 33100, Italy. markzeppieri@hotmail.com
Received: March 1, 2023
Peer-review started: March 1, 2023
First decision: April 21, 2023
Revised: April 24, 2023
Accepted: May 15, 2023
Article in press: May 15, 2023
Published online: June 20, 2023
Processing time: 111 Days and 1.5 Hours
Abstract

Eosinophilic esophagitis (EoE) is a chronic eosinophil inflammation that seems to be T helper type 2 antigen-driven. The disease is one of several eosinophilic gastrointestinal disorders in which there appears to be inflammation of the gastrointestinal tract without any apparent underlying causes. Differential diagnosis needs to be made with gastroesophageal reflux, which is characterized by chronic inflammation due to gastric refluxate from disorders related to motility. EoE, however, is considered a chronic allergic inflammatory disorder related to destructive tissue remodeling. There seems to be a higher prevalence of EoE in Western countries. It is typically found in atopic male individuals. Physiopathological risk factors include atopy, environmental factors, esophageal epithelial barrier dysfunctions, etc. EoE can cause several symptoms that include retrosternal burning sensation, dysphagia, food impaction, chronic reflux symptoms, nausea, and vomiting. Early diagnosis, which requires a biopsy to assess for esophageal inflammation, is essential for proper treatment. The aim of our brief overview is to summarize the current literature regarding the characteristics, diagnosis, complications, mechanisms of pathology, clinical features, influence of comorbidities, and treatment in patients with EoE.

Keywords: Eosinophilic esophagitis; Gastroesophageal reflux; Chronic allergic inflammatory disorder; Eosinophil inflammation; T helper 2

Core Tip: Eosinophilic esophagitis (EoE) is a chronic eosinophil inflammation. Differential diagnosis needs to be made with gastroesophageal reflux, which is characterized by chronic inflammation due to gastric refluxate from disorders related to motility. It is of clinical importance to diagnose, manage, and treat individuals with EoE. Patient outcomes, success of therapy, prevention of complications, and management of existing comorbidities depend on proper organ functioning.