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- Title
Diagnosis and management of eosinophilic esophagitis.
- Authors
Gupta, Milli; Grinman, Michelle
- Abstract
Eosinophilic esophagitis is a chronic inflammatory disease that affects both children and adults, with the highest incidence among young males with a history of atopy. The cause of the condition is not fully understood, but it involves a complex interaction between antigen exposures and genetic factors. Symptoms vary depending on age, with adults experiencing dysphagia and food impaction, while children may have feeding problems, abdominal pain, and vomiting. Diagnosis is based on clinical history and histological examination of esophageal biopsies. Treatment options include pharmacologic agents, elimination diets, and esophageal dilation if necessary. The approved formulation for adults in Canada is budesonide in an orodispersible tablet, which has shown improvement in histologic, endoscopic, and symptom outcomes. Other medications have shown inconsistent results and are not recommended. Dietary modifications can help identify food triggers and induce remission. Endoscopic dilation may be necessary for patients with esophageal strictures. Patient follow-up and shared decision-making are important for long-term management. Further research is needed to explore triggers, treatment strategies for refractory disease, and non-invasive monitoring techniques.
- Subjects
EOSINOPHILIC esophagitis; DIAGNOSIS; ESOPHAGEAL motility disorders; ESOPHAGEAL perforation; T helper cells; THYMIC stromal lymphopoietin
- Publication
Canadian Medical Association Journal (CMAJ), 2024, Vol 196, Issue 4, pE121
- Publication type
Article
- DOI
10.1503/cmaj.230378