Eosinophilic oesophagitis--a common disease, newly recognised

Area of Science:

• Gastroenterology
• Pathology
• Immunology

Background:

• Eosinophilic oesophagitis (EoE) is a distinct clinico-pathologic entity.
• It is increasingly recognized as a cause of dysphagia, distinct from gastro-oesophageal reflux disease.
• EoE diagnosis requires identifying high esophageal eosinophil concentrations.

Purpose of the Study:

• To highlight the importance of recognizing eosinophilic oesophagitis.
• To emphasize the diagnostic necessity of esophageal biopsy.
• To inform general physicians about EoE's prevalence and management.

Main Methods:

• Clinical diagnosis based on symptoms like dysphagia and food bolus obstruction.
• Endoscopic examination noting characteristic esophageal features (rings, furrows, strictures) or normal appearance.
• Histopathological analysis of esophageal biopsies to quantify eosinophil infiltration.

Main Results:

• Esophageal biopsy is essential for diagnosis, as endoscopic appearance can be normal.
• High eosinophil counts confirm eosinophilic oesophagitis.
• The condition is becoming more common and is not related to reflux.

Conclusions:

• Eosinophilic oesophagitis requires accurate diagnosis by general physicians.
• Biopsy is critical for confirming the diagnosis.
• Treatment options include topical steroids, leukotriene antagonists, dietary changes, and dilatations.