Eosinophilic esophagitis: An evidenced-based approach to diagnosis and treatment

Abstract

Eosinophilic oesophagitis is a unique form of non-IgE-mediated food allergy characterised by oesophageal eosinophilic infiltration. The prevalence of EoE has grown to currently represent the first cause of dysphagia and food impaction in children and young adults. Avoiding food triggers is the only therapy targeting the cause of the disease, but none of the currently available food allergy tests adequately predicts food triggers for EoE. Strategies based on the empirical elimination of food are the most effective and convenient in clinical practice. Proton pump inhibitors constitute an effective first-line therapy in half of patients, through a direct anti-inflammatory effect independent of its action on gastric acid secretion. Topical glucocorticosteroids budesonide and fluticasone reduce eosinophilic inflammation and reverse symptoms. This review includes the most relevant aspects of the epidemiology, diagnosis, treatment and monitoring of eosinophilic oesophagitis.

Keywords: Diet therapy: Dilation; Dietoterapia: Dilatación; Disease management; Drug therapy; Eosinophilic oesophagitis; Esofagitis eosinofílica; Glucocorticoides: Inhibidores de la bomba de protones; Glucocorticoids: Proton pump inhibitors; Manejo de la enfermedad; Tratamiento farmacológico.