Eosinophilic esophagitis overview: Difference between revisions

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==Causes==
==Causes==
*The causes of [[Eosinophilic esophagitis|EoE]] are as follows:<ref name="pmid1">{{cite journal |vauthors=Makar AB, McMartin KE, Palese M, Tephly TR, Kia L, Hirano I |title=Formate assay in body fluids: application in methanol poisoning |journal=Biochem Med |volume=13 |issue=2 |pages=117–26 |year=1975 |pmid=1 |pmc=4948861 |doi=10.1038/nrgastro.2015.75 |url=}}</ref><ref name="pmid27373195">{{cite journal |vauthors=Savarino EV, Tolone S, Bartolo O, de Cassan C, Caccaro R, Galeazzi F, Nicoletti L, Salvador R, Martinato M, Costantini M, Savarino V |title=The GerdQ questionnaire and high resolution manometry support the hypothesis that proton pump inhibitor-responsive oesophageal eosinophilia is a GERD-related phenomenon |journal=Aliment. Pharmacol. Ther. |volume=44 |issue=5 |pages=522–30 |year=2016 |pmid=27373195 |doi=10.1111/apt.13718 |url=}}</ref><ref name="pmid23797116">{{cite journal |vauthors=Straumann A |title=Eosinophilic esophagitis: a bulk of mysteries |journal=Dig Dis |volume=31 |issue=1 |pages=6–9 |year=2013 |pmid=23797116 |doi=10.1159/000347095 |url=}}</ref><ref name="pmid22307811">{{cite journal |vauthors=Straumann A |title=Eosinophilic esophagitis: rapidly emerging disorder |journal=Swiss Med Wkly |volume=142 |issue= |pages=w13513 |year=2012 |pmid=22307811 |doi=10.4414/smw.2012.13513 |url=}}</ref><ref name="pmid21429051">{{cite journal |vauthors=Schoepfer AM, Simon D, Straumann A |title=Eosinophilic oesophagitis: latest intelligence |journal=Clin. Exp. Allergy |volume=41 |issue=5 |pages=630–9 |year=2011 |pmid=21429051 |doi=10.1111/j.1365-2222.2011.03739.x |url=}}</ref><ref name="pmid21987875">{{cite journal |vauthors=Godat S, Moradpour D, Schoepfer A |title=[Eosinophilic esophagitis: update 2011] |language=French |journal=Rev Med Suisse |volume=7 |issue=307 |pages=1678–80, 1682 |year=2011 |pmid=21987875 |doi= |url=}}</ref><ref name="pmid14997131">{{cite journal |vauthors=Potter JW, Saeian K, Staff D, Massey BT, Komorowski RA, Shaker R, Hogan WJ |title=Eosinophilic esophagitis in adults: an emerging problem with unique esophageal features |journal=Gastrointest. Endosc. |volume=59 |issue=3 |pages=355–61 |year=2004 |pmid=14997131 |doi= |url=}}</ref>
The causes of [[Eosinophilic esophagitis|EoE]] are the food and [[pollen]] react with the lining of the [[esophagus]], these [[allergens]] cause the multiplication of [[eosinophils]] in the layers of the [[esophagus]] and produce a [[protein]] that causes [[inflammation]]. The [[inflammation]] further cause [[scarring]], excessive [[fibrous]] tissue deposition over the lining of the [[esophagus]] eventually leading to [[dysphagia]]. The [[dysphagia]] can sometimes worsen to cause food [[impaction]] and additional symptoms such as [[chest pain]].
*The food and [[pollen]] react with the lining of the [[esophagus]], these [[allergens]] cause the multiplication of [[eosinophils]] in the layers of the [[esophagus]] and produce a [[protein]] that causes [[inflammation]].
*The [[inflammation]] further cause [[scarring]], excessive [[fibrous]] tissue deposition over the lining of the [[esophagus]] eventually leading to [[dysphagia]].
*The [[dysphagia]] can sometimes worsen to cause food [[impaction]] and additional symptoms such as [[chest pain]].


==Differentiating {{PAGENAME}} from Other Diseases==
==Differentiating {{PAGENAME}} from Other Diseases==

Revision as of 23:13, 17 December 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Historical Perspective

Classification

Pathophysiology

Causes

The causes of EoE are the food and pollen react with the lining of the esophagus, these allergens cause the multiplication of eosinophils in the layers of the esophagus and produce a protein that causes inflammation. The inflammation further cause scarring, excessive fibrous tissue deposition over the lining of the esophagus eventually leading to dysphagia. The dysphagia can sometimes worsen to cause food impaction and additional symptoms such as chest pain.

Differentiating Eosinophilic esophagitis overview from Other Diseases

Eosinophilic esophagitis must be differentiated from other diseases that cause dysphagia such as reflux esophagitis, esophageal carcinoma, systemic sclerosis, esophageal spasm, pseudoachalasia, stroke, esophageal candidiasis and [[chagas d

Epidemiology and Demographics

Risk Factors

The risk factors of EoE are as follows bimodal age distribution common in both children and adults, male gender, cold and dry climate, EoE is common in people with a history of European ancestry, summer and fall, positive family history of EoE, history of allergies such as asthma, industrial exposures, environmental allergies, chronic respiratory disease, food allergies and atopic dermatitis.

Screening

Natural History, Complications, and Prognosis

Natural History

Complications

Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

The history and symptoms of eosinophilic esophagitis (EoE), dysphagia, regurgitation, cough, chest pain, food impaction, upper abdominal pain, vomiting. Clinical features in children are follows abdominal pain, nausea, emesis, failure to thrive. Clinical features in the adolescents and adults are as follows dysphagia, heartburn, food impaction, strictures.

Physical Examination

The physical examination of the patients with EoE is usually normal.

Laboratory Findings

Imaging Findings

The barium swallow of the esophagus shows multiple rings associated with eosinophilic esophagitis, There are no MRI nor CT scan findings associated with EoE. however, an MRI or a CT scan may be helpful in the diagnosis of complications of EoE such as tears, perforation strictures etc

Other Diagnostic Studies

Treatment

Medical Therapy

The optimal treatment of eosinophilic esophagitis remains uncertain. An eight-week course of therapy with topical corticosteroids (fluticasone or budesonide) may be used as the first-line pharmacologic therapy. Allergen elimination usually leads to improvement in dysphagia and reduction of eosinophil infiltration. Esophageal dilation of is generally reserved for refractory cases with esophageal stricture.

Surgery

Prevention

References

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