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Eosinophilic Esophagitis

Chronic, immune-mediated esophageal disease characterized by eosinophilic inflammation and food antigen-driven dysfunction.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

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What is Eosinophilic Esophagitis?

EoE is defined by esophageal dysfunction symptoms with ≥15 eosinophils per high-power field on biopsy, after exclusion of other causes.

Pathogenesis involves Th2 inflammation with IL-5, IL-13, and eotaxin-3 driving eosinophil recruitment and tissue remodeling.

Food allergens (milk, wheat, egg, soy, peanut, seafood) are the principal triggers in most patients.

Chronic inflammation leads to fibrostenosis, strictures, and narrow-caliber esophagus without effective therapy.

Symptoms

Dysphagia to solids, food impaction, and sensation of food sticking
Chest or epigastric pain and heartburn not relieved by PPI
Nausea, vomiting, and food avoidance behaviors
Failure to thrive in children; weight loss or slow eating in adults
Atopic comorbidities: asthma, rhinitis, atopic dermatitis
Endoscopic findings: rings, furrows, white exudates, narrow-caliber esophagus

Risk Factors

Atopic background, especially food allergy and eczema
Male sex (more common in adults)
Family history of EoE or atopy
Seasonal variation with aeroallergen exposure
Early-life antibiotic use, C-section delivery, and lack of breastfeeding
Genetic polymorphisms in TSLP, CAPN14, and filaggrin

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Dysphagia or food impaction, particularly requiring endoscopic disimpaction
  • Persistent heartburn or chest pain despite PPI therapy
  • Failure to thrive in a child with feeding difficulties

Treatment Methods

01
Proton pump inhibitor trial (high-dose, 8 weeks) as first-line pharmacologic therapy
02
Topical swallowed corticosteroids (budesonide, fluticasone) for persistent disease
03
Dietary therapy: empiric six-food or four-food elimination, or targeted elimination guided by testing
04
Biologic therapy with dupilumab for eligible patients with refractory disease
05
Endoscopic dilation for strictures causing persistent dysphagia
06
Long-term follow-up with periodic endoscopy and biopsy to confirm histologic response

Which Department to Visit?

You can visit our Dahiliye (İç Hastalıkları) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Dahiliye (İç Hastalıkları) Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.