Eosinophilic oesophagitis is an immune-mediated disease that is increasingly being recognised and should be considered in any patient presenting with a swallowing difficulty. Diagnosis relies on endoscopy and histological examination of oesophageal biopsy specimens. Treatment options include medication, diet and oesophageal dilatation.
- Eosinophilic oesophagitis (EoE) is an increasingly recognised cause of dysphagia and food impaction; other presentations include chest pain and refractory heartburn.
- EoE is associated with atopic conditions such as asthma, allergic rhinitis and atopic dermatitis.
- As dysphagia is an alarm symptom, affected patients should be referred for investigation, particularly to exclude oesophageal malignancy.
- Diagnosis of EoE relies on clinical and pathological features.
- Typical features include oesophageal rings, linear furrows, white exudates andcrepe-paper mucosa seen on endoscopy, and eosinophil-predominant inflammation on histological examination of biopsy specimens.
- Treatment options include diet, drugs and oesophageal dilatation; long-term strategies may be needed to prevent complications such as oesophageal stricture.