Document Detail

Proton pump inhibitors for eosinophilic oesophagitis.
MedLine Citation:
PMID:  23449027     Owner:  NLM     Status:  MEDLINE    
PURPOSE OF REVIEW: To review the significance and plausible mechanisms underlying 'proton pump inhibitor (PPI) responsive oesophageal eosinophilia' in eosinophilic oesophagitis (EoE).
RECENT FINDINGS: EoE is defined as an immune-mediated clinicopathologic condition characterized by oesophageal dysfunction and eosinophil-predominant inflammation. This new conceptual definition has been proposed partly due to a recently identified disease phenotype called 'PPI-responsive oesophageal eosinophilia'. Emerging data support the possibility that this condition represents a clinical response to anti-inflammatory properties of PPIs that are independent of effects on gastric acid.
SUMMARY: Currently, the diagnosis of EoE is reserved for patients with oesophageal eosinophilia and symptoms that do not respond to PPIs. This practice may not be appropriate, however, both because gastric acid suppression by PPIs might benefit EoE patients and because PPIs have anti-inflammatory properties that also might benefit EoE patients. More studies are sorely needed to understand the mechanisms underlying PPI-responsive oesophageal eosinophilia. Currently, a favourable response to PPI therapy should not be regarded as a proof of an underlying acid peptic disorder such as gastroesophageal reflux disease (GERD) nor should it preclude a diagnosis of EoE. Furthermore, it seems prudent to recommend a trial of PPI therapy for patients with oesophageal eosinophilia and symptoms, even when the diagnosis of EoE seems clear-cut.
Edaire Cheng
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current opinion in gastroenterology     Volume:  29     ISSN:  1531-7056     ISO Abbreviation:  Curr. Opin. Gastroenterol.     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-06-06     Completed Date:  2014-02-04     Revised Date:  2014-08-05    
Medline Journal Info:
Nlm Unique ID:  8506887     Medline TA:  Curr Opin Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  416-20     Citation Subset:  IM    
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MeSH Terms
Anti-Inflammatory Agents / therapeutic use
Eosinophilic Esophagitis / diagnosis,  drug therapy*
Proton Pump Inhibitors / therapeutic use*
Treatment Outcome
Grant Support
K12 HD-068369-01/HD/NICHD NIH HHS; K12 HD068369/HD/NICHD NIH HHS
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Proton Pump Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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