Eosinophilic esophagitis (EoE) is a chronic immune- or antigen-mediated disease characterized by typical symptoms of gastroesophageal reflux disease (GERD), with esophageal mucosal biopsies demonstrating squamous epithelium with eosinophil-predominant inflammation. EoE is a relatively newly described disease entity, recognized because of large subsets of children, adolescents, and young adults with continued reflux that is nonresponsive to acid-suppressive medication. It is more common in men than in women. Estimated prevalence of EoE is 0.4% in adult and pediatric populations in the Western world, with global incidence increasing substantially in recent decades.

Clinical manifestations vary by age, with children presenting with feeding difficulties, failure to thrive, vomiting, heartburn, and abdominal pain and adolescents and adults typically presenting with dysphagia and food impaction. EoE should be considered in adults with GERD not responsive to proton pump inhibitor therapy or with atypical chest pain. Important risk factors for development of EoE include food allergies, environmental allergies, asthma, atopic dermatitis, and family history of EoE. EoE should be considered in patients presenting with food impactions of unclear etiology.

Related topics: eosinophilic gastroenteritis, esophageal stricture