Therapeutic concepts in adult and paediatric eosinophilic oesophagitis

Nat Rev Gastroenterol Hepatol. 2012 Dec;9(12):697-704. doi: 10.1038/nrgastro.2012.182. Epub 2012 Sep 25.


Eosinophilic oesophagitis (EoE) was first described in the early 1990s. Although initially reported to be a rare entity, EoE has rapidly become a regularly diagnosed disease with a prevalence of approximately 1 in 2,000 individuals in the USA and Europe. The disease is characterized by a combination of oesophageal dysfunction and predominant eosinophilic infiltration of the oesophageal tissue. At diagnosis, other diseases that can be associated with oesophageal eosinophilic infiltration must be ruled out. Children with EoE present with a wide variety of symptoms, whereas adults mostly present with dysphagia for solid food and chest pain. Histologic features of EoE resemble those of T-helper type 2 inflammation. Endoscopy should be carried out to establish the diagnosis, but endoscopic abnormalities are not pathognomonic for EoE and the examination might not show histologic abnormality. Treatment modalities for EoE include drugs (corticosteroids, PPIs, antiallergic and biologic agents), hypoallergenic diets and oesophageal dilatation for strictures that are unresponsive to medical therapy. Unresolved eosinophilic inflammation leads to the formation of oesophageal strictures, which probably increase the risk of food bolus impactions. To date, long-term strategies for the therapeutic management of this chronic inflammatory disease remain poorly defined.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Age Factors*
  • Anti-Allergic Agents / therapeutic use
  • Child
  • Child, Preschool
  • Diet Therapy
  • Disease Management*
  • Eosinophilic Esophagitis / epidemiology*
  • Eosinophilic Esophagitis / genetics
  • Eosinophilic Esophagitis / therapy*
  • Female
  • Humans
  • Male
  • Prevalence
  • Proton Pump Inhibitors / therapeutic use
  • Treatment Outcome
  • Young Adult


  • Adrenal Cortex Hormones
  • Anti-Allergic Agents
  • Proton Pump Inhibitors