scholarly journals Recent Advances in the Recognition and Management of Eosinophilic Esophagitis

2015 ◽  
Vol 29 (5) ◽  
pp. 237-240 ◽  
Author(s):  
Gregory Eustace ◽  
Xianyong Gui ◽  
Marietta Iacucci
Keyword(s):  
Proton Pump ◽  
Eosinophilic Esophagitis ◽  
Targeted Therapies ◽  
Multidisciplinary Approach ◽  
Topical Steroid ◽  
Dietary Therapy ◽  
Immunological Reaction ◽  
Endoscopic Dilation ◽  
Food Bolus ◽  
Food Items

The incidence and recognition of eosinophilic esophagitis is increasing. Pathophysiological understanding of eosinophilic esophagitis is improving and an immunological reaction to ingested food is likely to play a significant role. Patients present with dysphagia and food bolus obstruction. Both histological and endoscopic criteria have been developed and validated. Dietary therapy, topical steroid therapy, proton pump inhibitors and endoscopic dilation are the main approaches to therapy; however, novel targeted therapies are being developed. Among the food items commonly implicated are wheat, dairy, nuts, soy, shellfish and eggs. A multidisciplinary approach to management in dedicated clinics may yield the best results.

DOZ047.120: The role of proton-pump inhibitors in eosinophilic esophagitis: focus on esophageal atresia children

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
R Tambucci ◽  
F Rea ◽  
M Malamisura ◽  
F Torroni ◽  
E F Romeo ◽  
...  
Keyword(s):  
General Population ◽  
Esophageal Atresia ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Eosinophilic Esophagitis ◽  
Topical Steroid ◽  
High Dose ◽  
Topical Steroids ◽  
High Prevalence

Abstract Introduction Since recently, after detection of eosinophilic predominant inflammation of esophagus a trial with proton-pump inhibitors (PPIs) was needed to individuate children with PPI-responsive esophageal eosinophilia (PPI-REE), only those non-responders received eosinophilic esophagitis (EoE) diagnosis. In 2018 updated international consensus suggested removing the PPI trial as a diagnostic criterion and consider PPIs as a treatment together with diets and topical steroids. The role of PPIs is evaluated in children with esophageal atresia (EA) and EoE versus EoE from general population. Method A retrospective chart review of both children with EA and EoE followed-up from at January 2005 has been performed. According to ESPGHAN guidelines published in 2014 patients showing eosinophilic inflammation received high-dose PPI trial to identified PPI-REE. Those non-responders were labeled as EoE and underwent to dietary and/or topical steroid treatment. Demographics and disease characteristics of EA patients with EoE were analyzed and compared with those with EoE from general population. Results Overall, 370 EA and 118 EoE patients were analyzed. Of them 15 EA-EoE patients were detected. Consequently, in our cohorts, 4.0% of EA patients developed EoE. Male-to-female prevalence ratio was of 2.55 with no difference in gender prevalence between groups. At diagnosis EoE-EA children were significantly younger compared to EoE group (mean: 5.1 vs 10.8 years; P < 0.0001). Peak EOS/HPF at diagnosis did not differ between groups (50.1 ± 26 vs 59.8 ± 29 EOS/HPF). No difference was observed in allergy prevalence between groups (53.8 vs 68.0%). PPI-REE was significantly more prevalent in EA-EoE group that in EoE group (66.6% vs 19.4%; P = 0.0004). Conclusion Similar gender distribution and high prevalence of allergy suggest that common genetic susceptibility factors for EoE exist. However, high prevalence of PPI-REE coupled early EoE onset might also suggest that other factors (e.g. esophageal motility disorders) might play a physiopathological role in EoE development in EA children. Our study suggests that a stepwise approach with PPIs as a first-line treatment for EoE management in EA children should still be considered.

scholarly journals Dual response to dietary/topical steroid and proton pump inhibitor therapy in adult patients with eosinophilic esophagitis

2016 ◽  
Vol 137 (3) ◽  
pp. 931-934.e2 ◽  
Author(s):  
Alfredo J. Lucendo ◽  
Ángel Arias ◽  
Jesús González-Cervera ◽  
José María Olalla ◽  
Javier Molina-Infante
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Eosinophilic Esophagitis ◽  
Topical Steroid ◽  
Proton Pump Inhibitor Therapy ◽  
Inhibitor Therapy ◽  
Adult Patients ◽  
Dual Response

Empiric proton pump inhibitor therapy after esophageal food impaction may mask eosinophilic esophagitis diagnosis at follow-up

2021 ◽  
Author(s):  
Luke Hillman ◽  
Sarah Donohue ◽  
Aimee Teo Broman ◽  
Patrick Hoversten ◽  
Eric Gaumnitz ◽  
...  
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Eosinophilic Esophagitis ◽  
Empiric Therapy ◽  
Proton Pump Inhibitor Therapy ◽  
Significant Heterogeneity ◽  
Food Impaction ◽  
Esophageal Food Impaction ◽  
The Impact

Summary Esophageal food impaction (EFI) is often the first presentation for patients with eosinophilic esophagitis (EoE); however, there is significant heterogeneity in the management of EFI. We aimed to study the impact of EFI management, particularly post-EFI medication prescriptions on EoE diagnosis, follow-up, and recurrence in patients with endoscopic features of EoE. In our retrospective study, adults presenting between 2007 and 2017 with EFI requiring endoscopic dis-impaction with endoscopic features of EoE (furrows, rings, and/or exudates) were included. We examined the impact of demographics and EFI management on EoE diagnosis, follow-up (esophagogastroduodenoscopy [EGD] or clinic visit within 6 months), and recurrence. We identified 164 cases of EFI due to suspected EoE. Biopsy was performed in 68 patients (41.5%), and 144 patients (87.8%) were placed on proton pump inhibitor (PPI) and/or swallow corticosteroids after EFI, including 88.5% of those not biopsied. PPI use at time of biopsy was negatively associated with EoE diagnosis (odds ratio: 0.39, confidence interval: 0.17–0.85). Sixty-one (37.4%) patients were lost to follow-up at 6 months. Recurrent EFI at 1 year occurred in 3.7% of patients. Medications, most commonly PPI, are frequently prescribed after EFI when the endoscopic features of EoE are present, which may mask the diagnosis of EoE on follow-up EGD. We estimated that for every five patients biopsied on PPI, one case of EoE is masked. As recurrent EFI within 1 year is uncommon, empiric therapy should be avoided until diagnostic biopsies are obtained. Further efforts to reduce loss to follow-up after EFI are also needed.

scholarly journals The First Asian Case Report of Eosinophilic Esophagitis in an Asymptomatic Adult: What About a Proton Pump Inhibitor Trial?

2009 ◽  
Vol 72 (3) ◽  
pp. 166-167 ◽  
Author(s):  
Javier Molina-Infante ◽  
Moises Hernandez-Alonso ◽  
Belen Perez-Gallardo ◽  
Elisa Martin-Noguerol
Keyword(s):  
Case Report ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Eosinophilic Esophagitis ◽  
Asymptomatic Adult

Seasonal recurrence of food bolus obstruction in eosinophilic esophagitis

2015 ◽  
Vol 45 (9) ◽  
pp. 939-943 ◽  
Author(s):  
H. L. Philpott ◽  
S. Nandurkar ◽  
F. Thien ◽  
S. Bloom ◽  
E. Lin ◽  
...  
Keyword(s):  
Eosinophilic Esophagitis ◽  
Food Bolus

scholarly journals Histologic similarities in children with eosinophilic esophagitis and proton pump inhibitor–responsive esophageal eosinophilia

2019 ◽  
Vol 143 (3) ◽  
pp. 1237-1240.e2 ◽  
Author(s):  
Nathalie Nguyen ◽  
Anna Baumgarten ◽  
Benjamin L. Wright ◽  
Kelley E. Capocelli ◽  
Zhaoxing Pan ◽  
...  
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Eosinophilic Esophagitis ◽  
Esophageal Eosinophilia
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