[Diagnosis and Treatment of Eosinophilic Esophagitis]

Eosinophilic esophagitis is a chronic inflammatory esophageal disease mediated by a type-2 immune response, mainly triggered by food allergens. Its incidence and prevalence have significantly increased in recent decades, making it a frequent cause of dysphagia and esophageal obstruction. The aim of this narrative review is to summarize current evidence of the diagnosis and treatment of EoE, with emphasis on clinical applications in Latin America.

A narrative review of literature published in PubMed and complementary databases up to May 2025 was conducted. Original studies, systematic reviews, clinical practice guidelines, and international consensus statements relevant to the diagnosis and management of EoE were included.

Diagnosis requires integration of clinical practice with endoscopic and histological findings, supported by standardized diagnostic scores such as EREFS and EoEHSS. In terms of treatment, proton pump inhibitors, swallowed topical corticosteroids, and elimination diets represent first-line options. The introduction of biologic agents, particularly dupilumab, has expanded therapeutic strategies for patients with refractory disease. Endoscopic dilation is safe and effective in fibrostenotic cases. Long-term monitoring should combine clinical, endoscopic, and histological assessments, as symptoms by themselves do not reliably reflect inflammatory activity.

EoE is a chronic condition that requires early diagnosis and comprehensive management. Despite therapeutic advances, challenges remain concerning the availability of specific drugs, reliable noninvasive biomarkers, and cost-effective monitoring strategies, which constitute priority areas for future research.