Eosinophilic Esophagitis
Basics
Description
A chronic, local, immune-mediated, esophageal disease characterized clinically in adults by dysphagia, food impaction, and heartburn and in children with nonspecific abdominal complaints, abdominal pain, and failure to thrive. Histologically, EoE is characterized by an eosinophil-predominate inflammation (1)[A].
Epidemiology
- All ages, most common in 20s to 30s; male > female, 3:1
- Leading cause of dysphagia and food impaction in children and young adults
Incidence
Incidence in general population is ~1 to 20/10,000 per year.
Prevalence
Gradually increasing, perhaps due to better case finding; 45 to 55/100,000
- Increased prevalence in patients with celiac disease
Etiology and Pathophysiology
- An atopic inflammatory disease; pathogenesis is an aberrant immune response to antigenic stimulation.
- Like eczema and asthma, T-helper 2 (TH2) lymphocytes play a role, as do mixed IgE and non–IgE-mediated allergic responses to food and environmental allergens.
- Although not well understood, the pathophysiology of EoE is postulated to be due to increased recruitment and activation of eosinophils in the esophagus by the eosinophil chemoattractants eotaxin-3, IL-5, and IL-13, which are ultimately responsible for inflammation and fibrotic change.
Genetics
- EoE susceptibility may be caused by polymorphisms in thymic stromal lymphopoietin protein (TSLP).
- Potential new subphenotype of EoE (may also overlap with GERD): proton pump inhibitor (PPI)–responsive esophageal eosinophilia (REE), where PPIs may act to decrease the inflammatory response in EoE
Risk Factors
- High rate of associated food and aero antigen allergies/anaphylaxis
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Citation
Domino, Frank J., et al., editors. "Eosinophilic Esophagitis." 5-Minute Clinical Consult, 33rd ed., Wolters Kluwer, 2025. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117528/all/Eosinophilic_Esophagitis.
Eosinophilic Esophagitis. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2025. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117528/all/Eosinophilic_Esophagitis. Accessed December 3, 2024.
Eosinophilic Esophagitis. (2025). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (33rd ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117528/all/Eosinophilic_Esophagitis
Eosinophilic Esophagitis [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2025. [cited 2024 December 03]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117528/all/Eosinophilic_Esophagitis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Eosinophilic Esophagitis
ID - 117528
ED - Domino,Frank J,
ED - Baldor,Robert A,
ED - Golding,Jeremy,
ED - Stephens,Mark B,
BT - 5-Minute Clinical Consult, Updating
UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117528/all/Eosinophilic_Esophagitis
PB - Wolters Kluwer
ET - 33
DB - Medicine Central
DP - Unbound Medicine
ER -