Endoscopic Features of Eosinophilic Gastrointestinal Diseases

Immunol Allergy Clin North Am. 2024 May;44(2):357-368. doi: 10.1016/j.iac.2024.01.007. Epub 2024 Feb 13.


Endoscopic evaluation with biopsies is a mainstay of the diagnosis of eosinophilic esophagitis (EoE) and non-EoE eosinophilic gastrointestinal diseases (EGIDs). Increasing knowledge has resulted in the development of 2 standardized scoring systems: the Endoscopic REFerence Score (EREFS) for EoE and the EG-REFS for eosinophilic gastritis, although the latter has not been validated. In EGIDs, diagnosis and follow-up focus on eosinophil infiltration in biopsies. In this article, we will discuss the most commonly used endoscopic scores in EoE and non-EoE EGIDs, their validity for the diagnosis and follow-up of disease activity, as well as endoscopic interventions and areas of uncertainty.

Keywords: Biopsies; Endoscopy; Eosinophilic esophagitis; Eosinophilic gastritis; Eosinophilic gastrointestinal diseases.

Publication types

  • Review

MeSH terms

  • Endoscopy / methods
  • Enteritis* / diagnosis
  • Enteritis* / therapy
  • Eosinophilia*
  • Eosinophilic Esophagitis* / diagnosis
  • Eosinophilic Esophagitis* / therapy
  • Gastritis* / diagnosis
  • Humans

Supplementary concepts

  • Eosinophilic enteropathy