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2015 ; 6
(4
): 150-8
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Eosinophilic esophagitis: From pathophysiology to treatment
#MMPMID26600973
D'Alessandro A
; Esposito D
; Pesce M
; Cuomo R
; De Palma GD
; Sarnelli G
World J Gastrointest Pathophysiol
2015[Nov]; 6
(4
): 150-8
PMID26600973
show ga
Eosinophilic esophagitis (EoE) is a chronic immune disease, characterized by a
dense eosinophilic infiltrate in the esophagus, leading to bolus impaction and
reflux-like symptoms. Traditionally considered a pediatric disease, the number of
adult patients with EoE is continuously increasing, with a relatively higher
incidence in western countries. Dysphagia and food impaction represent the main
symptoms complained by patients, but gastroesophageal reflux-like symptoms may
also be present. Esophageal biopsies are mandatory for the diagnosis of EoE,
though clinical manifestations and proton pump inhibitors responsiveness must be
taken into consideration. The higher prevalence of EoE in patients suffering from
atopic diseases suggests a common background with allergy, however both the
etiology and pathophysiology are not completely understood. Elimination diets are
considered the first-line therapy in children, but this approach appears less
effective in adults patients, who often require steroids; despite medical
treatments, EoE is complicated in some cases by esophageal stricture and
stenosis, that require additional endoscopic treatments. This review summarizes
the evidence on EoE pathophysiology and illustrates the safety and efficacy of
the most recent medical and endoscopic treatments.