Perspectives in clinical gastroenterology and hepatologyDiagnosis and Management of Eosinophilic Esophagitis
Section snippets
Diagnosis of Eosinophilic Esophagitis
The first consensus guidelines for diagnosis of EoE were published in 2007 and represented a major milestone.30 Before this, there was marked variability in the literature with regard to how the disease was defined,31 and after this, there has been some degree of increasing uniformity in diagnosis, although this has not been complete.32, 33 The 2007 guidelines emphasized that EoE was a clinicopathologic condition, meaning that both clinical and histologic features were needed for diagnosis and
Treatment of Eosinophilic Esophagitis
Treatment of EoE is focused on improving both patient symptoms and histology on esophageal biopsies as well as correcting or preventing complications such as esophageal strictures or food impactions leading to esophageal rupture, but there are currently few data to support specific treatment end points.1, 85 Ideally, the goal would be complete symptom resolution and normalization of the esophageal epithelium with elimination of all eosinophils, but in practice, symptom improvement and
Conclusions
During the past 2 decades, EoE has made a remarkable transformation from a rarely seen, case-reportable diagnosis to a commonly encountered condition in gastrointestinal practice. Because no individual clinical, endoscopic, or histologic feature alone is pathognomonic, EoE is a clinicopathologic condition; to diagnose EoE, all features must be considered together. The most recent consensus guidelines state that EoE is diagnosed when there are symptoms of esophageal dysfunction, ≥15 eos/hpf on
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Conflicts of interest The author discloses no conflicts.
Funding Supported in part by NIH award number 1K23 DK090073-01.