Eosinophilic esophagitis

Update in diagnosis and management. Position paper by the Italian Society of Gastroenterology and Gastrointestinal Endoscopy (SIGE)

Nicola de Bortoli, Roberto Penagini, Edoardo Savarino, Santino Marchi

Research output: Contribution to journalReview article

10 Citations (Scopus)

Abstract

Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease of the esophagus characterized by symptoms related to esophageal dysfunction, as well as significant esophageal eosinophilia. The entity exists worldwide but has been most extensively studied in Western countries. However, a wide range of symptoms has been noticed such as chest pain or gastro-esophageal reflux disease-like symptoms. Upper gastro-intestinal endoscopy and esophageal biopsies are crucial for the diagnosis. Endoscopy might be normal or reveal typical patterns such as rings, furrows, exudates, edema, and stricture. Two to four biopsies should be performed both in the distal and in the proximal esophagus, and 15 eosinophils per high power field within the esophageal epithelium are the minimal threshold to diagnose eosinophilic esophagitis. Allergy testing is recommended, although its impact to orient treatment remains to be demonstrated. Eosinophilic esophagitis treatment includes medical treatment, diet and endoscopic dilation. Proton pump inhibitors are the first-line therapy as up to 50% of patients respond well to proton pump inhibitors irrespective of objective evidence of GERD. Topical viscous corticosteroids or elimination diet are the treatment of choice in case of unresponsiveness to proton pump inhibitors.

Original languageEnglish
Pages (from-to)254-260
Number of pages7
JournalDigestive and Liver Disease
Volume49
Issue number3
DOIs
Publication statusPublished - Mar 1 2017

Fingerprint

Eosinophilic Esophagitis
Gastrointestinal Endoscopy
Gastroenterology
Proton Pump Inhibitors
Gastroesophageal Reflux
Esophagus
Endoscopy
Esophageal Diseases
Diet
Biopsy
Therapeutics
Immune System Diseases
Eosinophilia
Exudates and Transudates
Chest Pain
Eosinophils
Dilatation
Edema
Adrenal Cortex Hormones
Hypersensitivity

Keywords

  • Biopsies
  • Eosinophilic esophagitis
  • PPI-responsive eosinophilic esophagitis
  • Proton pump inhibitors
  • Steroids
  • Upper endoscopy

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Eosinophilic esophagitis : Update in diagnosis and management. Position paper by the Italian Society of Gastroenterology and Gastrointestinal Endoscopy (SIGE). / de Bortoli, Nicola; Penagini, Roberto; Savarino, Edoardo; Marchi, Santino.

In: Digestive and Liver Disease, Vol. 49, No. 3, 01.03.2017, p. 254-260.

Research output: Contribution to journalReview article

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