The manuscript titled “Clinical characteristics and treatment of eosinophilic esophagitis in an adult population in Colombia” by Juliao-Baños et al.1 is a study that contributes interesting data on eosinophilic esophagitis (EoE) in the Latin American context.

The clinical aspect is of greater interest; the patient clinical profile is similar to that of recently published Latin American studies2,3: male sex, middle age, and the presentation of dysphagia and atopy. There are some differences in the proportions of these important characteristics between the 3 studies, but they are most likely due to the methodological design, number of patients, and population characteristics. The low percentage of atopy (37%) is striking, given that it is one of the most important parameters in the clinical profile. A higher association has been reported in Latin American studies (51.6% and 60.5%).2,3

On the other hand, almost one-third of the patients (31%) presented with symptoms of gastroesophageal reflux, reaffirming the need for increasing diagnostic thoroughness and avoiding the indiscriminate use of proton pump inhibitors (PPIs), before making the definitive diagnosis.

Regarding treatment, the results are difficult to interpret accurately because more than half of the patients received combination treatments (57.2%). Moreover, whether a homogeneous methodological pattern was followed for the clinical and histologic response evaluations was not specified.

Nevertheless, it is interesting that the most widely used treatment was that of PPIs (88%), alone or in combination, with a histologic response of 63.4%, which is within the reported range. Also noteworthy is the use of a restrictive dietary treatment in 45%, given that it is difficult to implement costly, due to multiple endoscopies, biopsies, nutritional support. The authors reported effectiveness comparable to or higher than that reported in the literature (69%).4 Topical steroids were used in 27% of the patients, obtaining histologic remission in 64.2%.

Of studies published so far, this work by Juliao-Baños et al. has the highest number of adult Latin American patients (152), made possible by its multicenter design and the participation of 16 gastroenterology teams in Colombia. It responds to the need for conducting multicenter or multinational projects for the study of emerging diseases and those of low prevalence in our environment, such as EoE.

Despite the abovementioned methodological limitations, this study is an important step in the effort to carry out multinational projects that address different aspects of the disease, through prospective studies with clear aims, as well as through consensuses developed by renowned Latin American experts, to define guidelines for the diagnostic and therapeutic approach to the disease in our patients. The worldwide incidence and prevalence of EoE is on the rise,5 signifying that most certainly we will be detecting it more frequently in our environment.