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Can anyone give me information on eosinophilic esophagitis?
I am curious about this conditon. Is there a cure for it? Do infants with it grow out of it? Best answer: Eosinophilic esophagitis is a recently and increasingly recognized disorder in adults. It is characterized clinically by dysphagia, often accomp
I am curious about this conditon. Is there a cure for it? Do infants with it grow out of it?
Best answer:
Eosinophilic esophagitis is a recently and increasingly recognized disorder in adults. It is characterized clinically by dysphagia, often accompanied by food impaction. An allergic history or asthma is not an uncommon accompanying historical feature. Often, the history of dysphagia dates to adolescence. Characteristically, endoscopy reveals evidence of a long narrowing beneath a proximal stenosis or stricture of the esophagus, a corrugated or ringed appearance, or a generalized narrow appearance of the esophagus. Frank esophagitis is not part of the macroscopic endoscopic picture of eosinophilic esophagitis. After dilation of the esophagus, it is not uncommon to see "fracturing" of the mucosa that can be alarmingly long and deep. Severe chest pain following dilation is not unusual with this disease. All of these endoscopic features are very suggestive of a diagnosis of eosinophilic esophagitis, but are not diagnostic. The diagnosis is made by the finding of increased eosinophils in the mucosa on an endoscopic biopsy specimen. The degree of eosinophilic infiltration "diagnostic" of eosinophilic esophagitis has not been determined, and has been observed to be quite variable.
The currently recommended treatment for eosinophilic esophagitis is based on the hypothesis that this disorder represents an epithelial response to an antigen (allergic response). Thus, avoidance of foods that seem to cause esophageal symptoms, and use of antisecretory compounds (proton-pump inhibitors) and/or anti-inflammatory agents (fluticasone or montelukast) has been recommended on the basis of observational and uncontrolled experience. However, it is important to note that none of these therapies has ever been demonstrated as effective in improving outcomes in patients with eosinophilic esophagitis in randomized, controlled clinical trials, and thus, the recommendation for this treatment approach is based on theory and observation, not fact.
Additionally, the natural history of this disorder has not been well characterized, but appears to be marked by periods of spontaneous remission and exacerbations that are not linked to specific factors, although food allergies and exposure have been implicated.
Within the past few years, eosinophilic esophagitis has emerged from a medical curiosity to one that has received considerable attention in the literature. Several reasons might explain this interest. First, whereas this entity was considered mostly to be a problem of children, many more adults are being diagnosed with this disease. Second, it has also become clear that many of the cases of refractory gastroesophageal reflux disease (GERD) in children and young adults may in fact be eosinophilic esophagitis. Third, it has become an important etiology for several previously poorly understood processes in the past, including patients with unexplained dysphagia, small caliber and ringed esophagus, and part of the differential diagnosis of unexplained nausea and vomiting. Fourth, it has become another variant of allergic type disorders of the gastrointestinal tract. Therefore, the disease is of interest to gastroenterologists, and allergists and immunologists as well. In this article, available data on eosinophilic esophagitis are given with attention to the large body of more recent literature trying to better define all aspects of this curious entity.
Best answer:
http://www.medscape.com/viewarticle/4954...
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