Document Detail

Eosinophilic esophagitis.
MedLine Citation:
PMID:  15367851     Owner:  NLM     Status:  MEDLINE    
PURPOSE OF REVIEW: Eosinophilic esophagitis (EE) is an isolated, eosinophilic inflammation of the esophagus. In the past, the symptoms of EE were often confused for gastroesophageal reflux (GER). Thus, many physicians unsuccessfully treated patients with EE with medications used for GER. Because the incidence of EE is rising and EE is easily diagnosed by endoscopy with biopsy, it is important for physicians to not only accurately identify patients with EE but also understand the treatment options available. RECENT FINDINGS: While patients with acid reflux may have a few eosinophils, patients with EE have high levels of eosinophils in their esophagus as part of an allergic response to food antigens. The inflammation may cause abdominal pain, nausea, or vomiting. If EE persists for years, it may cause a narrowing of the esophagus that leads to dysphagia. In young children, many of the symptoms of EE mimic those of gastroesophageal reflux. Medications used to treat reflux are not effective against EE. Over the past few years, many new reports and retrospective studies have been written on the subject of EE. The focus of these papers concentrated on the etiology and treatment of EE. SUMMARY: The diagnosis of EE requires a biopsy of the esophagus. Typical allergy tests are not effective for diagnosis of EE because the allergic reaction involved in EE is non-IgE mediated. The most commonly involved foods include milk, eggs, nuts, beef, wheat, fish, shellfish, corn, and soy; however, almost all foods have been implicated. Because allergy tests are often unable to determine the causative foods, complete elimination of all foods is often required. In these cases, patients must be placed on a strict elemental formula for 1 to 3 months to heal the esophagus. Repeat endoscopy with biopsy is often necessary. Several medications have been used including corticosteroids, cromolyn sodium, and leukotriene inhibitors. This review discusses the past year's literature, concentrating on the etiology, diagnosis, and treatment of EE in both children and adults.
Chris A Liacouras; Eduardo Ruchelli
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in pediatrics     Volume:  16     ISSN:  1040-8703     ISO Abbreviation:  Curr. Opin. Pediatr.     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-09-15     Completed Date:  2005-02-15     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9000850     Medline TA:  Curr Opin Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  560-6     Citation Subset:  IM    
Department of Anatomic Pathology, University of Pennsylvania School of Medicine, Pennsylvania 19104, USA.
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MeSH Terms
Adrenal Cortex Hormones / therapeutic use
Deglutition Disorders / diagnosis,  etiology,  therapy
Diagnosis, Differential
Eosinophilia / diagnosis*,  etiology,  therapy
Eosinophils / metabolism
Esophagitis / diagnosis*,  etiology,  therapy
Food Hypersensitivity / complications
Gastroesophageal Reflux / diagnosis
Reg. No./Substance:
0/Adrenal Cortex Hormones

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