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Eosinophilic esophagitis.
Curr Opin Pediatr 2004; 16(5):560-6CO

Abstract

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.

Authors+Show Affiliations

Department of Anatomic Pathology, University of Pennsylvania School of Medicine, Pennsylvania 19104, USA. liacouras@email.chop.eduNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

15367851

Citation

Liacouras, Chris A., and Eduardo Ruchelli. "Eosinophilic Esophagitis." Current Opinion in Pediatrics, vol. 16, no. 5, 2004, pp. 560-6.
Liacouras CA, Ruchelli E. Eosinophilic esophagitis. Curr Opin Pediatr. 2004;16(5):560-6.
Liacouras, C. A., & Ruchelli, E. (2004). Eosinophilic esophagitis. Current Opinion in Pediatrics, 16(5), pp. 560-6.
Liacouras CA, Ruchelli E. Eosinophilic Esophagitis. Curr Opin Pediatr. 2004;16(5):560-6. PubMed PMID: 15367851.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Eosinophilic esophagitis. AU - Liacouras,Chris A, AU - Ruchelli,Eduardo, PY - 2004/9/16/pubmed PY - 2005/2/16/medline PY - 2004/9/16/entrez SP - 560 EP - 6 JF - Current opinion in pediatrics JO - Curr. Opin. Pediatr. VL - 16 IS - 5 N2 - 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. SN - 1040-8703 UR - https://www.unboundmedicine.com/medline/citation/15367851/Eosinophilic_esophagitis_ L2 - http://dx.doi.org/10.1097/01.mop.0000141071.47572.eb DB - PRIME DP - Unbound Medicine ER -