Eosinophilic esophagitis overview: Difference between revisions
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==Classification== | ==Classification== | ||
There is no established system for the classification of Eosinophilic esophagitis (EoE). | |||
==Pathophysiology== | ==Pathophysiology== | ||
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==Screening== | ==Screening== | ||
There is insufficient evidence to recommend routine screening for Eosinophilic esophagitis (EoE). | |||
==Natural History, Complications, and Prognosis== | ==Natural History, Complications, and Prognosis== | ||
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===Complications=== | ===Complications=== | ||
*The [[complications]] of the [[EoE]] are as follows:<ref name="pmid22040638">{{cite journal |vauthors=Straumann A |title=The natural history and complications of eosinophilic esophagitis |journal=Thorac Surg Clin |volume=21 |issue=4 |pages=575–87 |year=2011 |pmid=22040638 |doi=10.1016/j.thorsurg.2011.09.004 |url=}}</ref><ref name="pmid24117638">{{cite journal |vauthors=Chehade M, Lucendo AJ, Achem SR, Souza RF |title=Causes, evaluation, and consequences of eosinophilic esophagitis |journal=Ann. N. Y. Acad. Sci. |volume=1300 |issue= |pages=110–8 |year=2013 |pmid=24117638 |doi=10.1111/nyas.12243 |url=}}</ref><ref name="pmid23891531">{{cite journal |vauthors=Saillen E, Cellier C, Naneix AL, Canioni D, Bruneval P, Pouchot J, Georgin-Lavialle S |title=[Eosinophilic esophagitis] |language=French |journal=Presse Med |volume=43 |issue=1 |pages=34–8 |year=2014 |pmid=23891531 |doi=10.1016/j.lpm.2013.03.012 |url=}}</ref> | |||
*[[Scarring]] of [[esophagus]]-leading to [[dysphagia]] | |||
*[[Esophageal]] [[stenosis]]- causing food stuck | |||
*[[Tears]] or [[perforation]] during the [[endoscopy]] or [[retching]] leading to [[boerhaave syndrome]]. | |||
===Prognosis=== | ===Prognosis=== | ||
Revision as of 23:15, 17 December 2017
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Eosinophilic Esophagitis Microchapters |
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Differentiating Eosinophilic Esophagitis from other Diseases |
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Diagnosis |
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Treatment |
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Eosinophilic esophagitis overview On the Web |
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Risk calculators and risk factors for Eosinophilic esophagitis overview |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Historical Perspective
Classification
There is no established system for the classification of Eosinophilic esophagitis (EoE).
Pathophysiology
Causes
The causes of EoE are the food and pollen react with the lining of the esophagus, these allergens cause the multiplication of eosinophils in the layers of the esophagus and produce a protein that causes inflammation. The inflammation further cause scarring, excessive fibrous tissue deposition over the lining of the esophagus eventually leading to dysphagia. The dysphagia can sometimes worsen to cause food impaction and additional symptoms such as chest pain.
Differentiating Eosinophilic esophagitis overview from Other Diseases
Eosinophilic esophagitis must be differentiated from other diseases that cause dysphagia such as reflux esophagitis, esophageal carcinoma, systemic sclerosis, esophageal spasm, pseudoachalasia, stroke, esophageal candidiasis and [[chagas d
Epidemiology and Demographics
Risk Factors
The risk factors of EoE are as follows bimodal age distribution common in both children and adults, male gender, cold and dry climate, EoE is common in people with a history of European ancestry, summer and fall, positive family history of EoE, history of allergies such as asthma, industrial exposures, environmental allergies, chronic respiratory disease, food allergies and atopic dermatitis.
Screening
There is insufficient evidence to recommend routine screening for Eosinophilic esophagitis (EoE).
Natural History, Complications, and Prognosis
Natural History
Complications
- The complications of the EoE are as follows:[1][2][3]
- Scarring of esophagus-leading to dysphagia
- Esophageal stenosis- causing food stuck
- Tears or perforation during the endoscopy or retching leading to boerhaave syndrome.
Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
The history and symptoms of eosinophilic esophagitis (EoE), dysphagia, regurgitation, cough, chest pain, food impaction, upper abdominal pain, vomiting. Clinical features in children are follows abdominal pain, nausea, emesis, failure to thrive. Clinical features in the adolescents and adults are as follows dysphagia, heartburn, food impaction, strictures.
Physical Examination
The physical examination of the patients with EoE is usually normal.
Laboratory Findings
Imaging Findings
The barium swallow of the esophagus shows multiple rings associated with eosinophilic esophagitis, There are no MRI nor CT scan findings associated with EoE. however, an MRI or a CT scan may be helpful in the diagnosis of complications of EoE such as tears, perforation strictures etc
Other Diagnostic Studies
Treatment
Medical Therapy
The optimal treatment of eosinophilic esophagitis remains uncertain. An eight-week course of therapy with topical corticosteroids (fluticasone or budesonide) may be used as the first-line pharmacologic therapy. Allergen elimination usually leads to improvement in dysphagia and reduction of eosinophil infiltration. Esophageal dilation of is generally reserved for refractory cases with esophageal stricture.
Surgery
Prevention
References
- ↑ Straumann A (2011). "The natural history and complications of eosinophilic esophagitis". Thorac Surg Clin. 21 (4): 575–87. doi:10.1016/j.thorsurg.2011.09.004. PMID 22040638.
- ↑ Chehade M, Lucendo AJ, Achem SR, Souza RF (2013). "Causes, evaluation, and consequences of eosinophilic esophagitis". Ann. N. Y. Acad. Sci. 1300: 110–8. doi:10.1111/nyas.12243. PMID 24117638.
- ↑ Saillen E, Cellier C, Naneix AL, Canioni D, Bruneval P, Pouchot J, Georgin-Lavialle S (2014). "[Eosinophilic esophagitis]". Presse Med (in French). 43 (1): 34–8. doi:10.1016/j.lpm.2013.03.012. PMID 23891531.