Eosinophilic esophagitis: An aerodigestive perspective

Eosinophilic esophagitis (EoE) is an immune-mediated inflammatory condition of the esophagus that is characterized by esophageal dysfunction and distinct histopathologic findings of elevated eosinophils in the esophageal mucosa. EoE can present in the aerodigestive patient with a variety of symptoms ranging from feeding difficulty to extraesophageal symptoms such as chronic cough. Routine evaluation for EoE should be performed in high-risk patients such as esophageal atresia/tracheoesophageal fistula and should be considered for those undergoing evaluation for laryngotracheal reconstruction surgery. When selecting treatments for EoE in aerodigestive patients, the clinician should consider limitations such as ability to take oral treatments and other nutritional considerations in the management of these fragile patients. Long-term monitoring of aerodigestive patients with EoE should include assessment of growth, feeding, nutrition, and follow-up for resolution of the primary presenting symptoms often requires continued involvement of the multidisciplinary team which includes a dietitian and feeding therapist.