Eosinophilic Esophagitis: Diagnosis and Current Management.

Area of Science:

• Gastroenterology
• Immunology
• Pathology

Background:

• Eosinophilic esophagitis (EoE) is an increasing global health concern characterized by eosinophil-rich inflammation.
• It affects all ages, with peak prevalence in adults aged 30-40, causing esophageal dysfunction and remodeling.
• Progressive EoE can lead to strictures and reduced esophageal diameter.

Purpose of the Study:

• To review current diagnostic methods for EoE.
• To discuss available and emerging therapeutic strategies for EoE management.
• To propose a treatment algorithm for EoE.

Main Methods:

• Histological confirmation with at least 15 eosinophils/HPF via esophageal biopsies during upper endoscopy.
• Evaluation of dietary elimination diets (elemental, 2-, 4-, 6-food elimination).
• Assessment of pharmacologic treatments (PPIs, topical corticosteroids) and esophageal dilation.

Main Results:

• Step-up dietary approaches are effective in up to 79% of cases, minimizing dietary restrictions.
• Proton pump inhibitors and topical corticosteroids are primary medical therapies.
• Esophageal dilation provides immediate symptomatic relief in 95% of patients with strictures.

Conclusions:

• EoE is a chronic condition requiring long-term management.
• A structured approach combining dietary modifications, pharmacotherapy, and dilation is crucial.
• The proposed algorithm aims to optimize diagnosis and treatment for EoE patients.