Peer Reviewed
Feature Article Gastroenterology
Eosinophilic oesophagitis: diagnosis and management
Recent articles on:
Oesophagus disorders
Oesophagus disorders
Recent articles on:
Swallowing disorders
Swallowing disorders
Abstract
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.
Key Points
- 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.
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