Korean J Gastroenterol.  2022 Mar;79(3):99-108. 10.4166/kjg.2021.119.

Diagnosis and Treatment of Eosinophilic Esophagitis

• Kim SJ
• Choi CW
• Hwang CS

• KMID: 2527477
• DOI: http://doi.org/10.4166/kjg.2021.119

Abstract

Eosinophilic esophagitis (EoE) is a chronic, immune/antigen-mediated esophageal disease characterized by symptoms of esophageal dysfunction and eosinophil-predominant inflammation. The diagnostic criteria for EoE have changed with our growing knowledge over the past two decades. Esophageal eosinophilia, which responds histologically to a proton pump inhibitor (PPI) is not a distinct disease but a subset of EoE. An endoscopic scoring system that relies on the assessment of exudates, rings, edema, furrows, and strictures is a useful tool for assessing endoscopic severity. PPIs are regarded as safe and effective first-line treatments for EoE. Oral topical corticosteroids or dietary therapy are also options for first-line treatment. Endoscopic dilation is effective for relieving the dysphagia symptoms of a patient with an esophageal stricture.

Keyword

Eosinophilic esophagitis; Proton pump inhibitors; Steroids

Figure

• 

  Fig. 1 Endoscopic findings in patients with eosinophilic esophagitis. (A) Decreased vascularity is present. (B) Cocentric rings are present. (C) Granular white exudates are present in the lower esophagus. (D) Linear furrows run along the longitudinal axis of the esophagus.

• 

  Fig. 2 Histologic findings of eosinophilic esophagitis (hematoxylin and eosin, ×400). Surface sloughing of squamous cells with abundant eosinophils was present and is one of the important features that can distinguish eosinophilic esophagitis from gastroesophageal reflux disease or eosinophilic gastroenteritis.

• 

  Fig. 3 Treatment algorithm for patients with eosinophilic esophagitis.

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