Eosinophilic esophagitis: An aerodigestive perspective

Area of Science:

• Gastroenterology
• Immunology
• Pediatric Otolaryngology

Background:

• Eosinophilic esophagitis (EoE) is an immune-mediated esophageal inflammatory disease.
• It presents with esophageal dysfunction and elevated eosinophils in the esophageal mucosa.
• EoE can manifest with diverse symptoms, including feeding difficulties and extraesophageal issues like chronic cough in aerodigestive patients.

Purpose of the Study:

• To highlight the importance of evaluating aerodigestive patients for EoE.
• To guide treatment selection considering patient-specific limitations.
• To emphasize the need for multidisciplinary long-term monitoring.

Main Methods:

• Literature review on EoE in aerodigestive patients.
• Analysis of clinical presentation and diagnostic considerations.
• Discussion of treatment modalities and long-term management strategies.

Main Results:

• Routine EoE evaluation is recommended for high-risk aerodigestive patients (e.g., esophageal atresia/tracheoesophageal fistula).
• Consideration for EoE is advised for patients undergoing laryngotracheal reconstruction surgery.
• Treatment requires careful consideration of oral intake ability and nutritional status.

Conclusions:

• Aerodigestive patients with EoE necessitate tailored management strategies.
• Long-term monitoring should encompass growth, feeding, nutrition, and symptom resolution.
• A multidisciplinary team approach, including dietitians and feeding therapists, is crucial for optimal outcomes.