Eosinophilic esophagitis natural history
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Overview
Natural History
- The natural course of primary eosinophilic esophagitis is as follows:[1]
- In patients with EoE, symptoms persist over years raising suspicion that a chronic inflammatory process is an underlying event responsible for it.
- The inflammatory activity is proportional to the density of the eosinophilic infiltration in the esophageal tissue.
- Similar to asthma, EoE has chronic persistent eosinophilic inflammation and can eventually lead to irreversible structural changes of the esophagus which is called re-modeling of the esophagus.
- The esophageal mucosa in patients with a longstanding EoE is characterized by a loss of elasticity.
- On histologic examination of the subepithelial compartments of the esophagus show an increase in the fibrous tissue.
- The endosonographic studies of the esophagus in patients with EoE shows following findings:
- Thickening of the mucosa
- Thickening of the submucosal, and muscularis propria layers
- In patients with EoE, the chronic eosinophilic inflammation leads to an increased deposition of the fibrous connective tissue which in turn causes the remodeling of the esophagus hindering the esophageal transport.