Esophageal dilation in eosinophilic esophagitis

Area of Science:

• Gastroenterology
• Otolaryngology

Background:

• Tissue remodeling and scarring are common in adult eosinophilic esophagitis (EoE) with long-standing disease.
• This remodeling causes significant symptoms like solid food dysphagia and recurrent food impactions.
• Current management often involves medications or dietary restrictions.

Purpose of the Study:

• To review the history and safety of esophageal dilation in EoE patients.
• To outline a safe and effective method for performing esophageal dilation.
• To highlight dilation as a viable alternative to long-term medical or dietary management.

Main Methods:

• Review of recent case series on esophageal dilation in EoE.
• Description of a graduated dilation technique over one to several sessions.
• Emphasis on achieving a final diameter of 15-18 mm.

Main Results:

• Esophageal dilation is safe and effective in EoE patients, with symptom relief lasting an average of two years.
• Graduated dilation to 15-18 mm is key to successful outcomes.
• Mucosal tears are expected signs of successful dilation, not complications.

Conclusions:

• Esophageal dilation is a safe and effective procedure for managing tissue remodeling in adult EoE.
• Graduated dilation offers significant symptom relief and may be preferred over long-term medication or diet.
• This approach is supported by recent EoE consensus statements and guidelines.