Eosinophilic Esophagitis

Eosinophilic Esophagitis Overview

Eosinophilic Esophagitis (EoE) is an inflammatory disease characterized by a Th2-type response that leads to chronic, eosinophil-predominant, inflammation of the esophagus. This chronic inflammation, when untreated, can cause esophageal remodeling, odynophagia and food impaction. EoE is the most common cause of persistent dysphagia in developed countries.

Although the first case was reported in 1978, EoE was not identified as a unique disease entity until the early 1990s. Since then, the increase in incidence of EoE has exceeded that which can be attributed to increasing recognition alone. There is no known single cause but it is believed to be caused by environmental factors possibly combined with genetic predisposition as a major driver of disease prevalence. In the United States, estimates of annual costs attributable to the treatment of patients with EoE approach 1.4 billion dollars.

Symptoms in children are variable and can include dysphagia, epigastric pain, vomiting and food impaction. Children with EoE may have subtle symptoms or adjust their mealtime habits to mitigate the more overt symptoms of choking and gagging, both of which can delay diagnosis.

• Adjustments may include excessive chewing of food, eating softer foods, eating smaller quantities and drinking frequently during meals.

The primary goal of intervention is to treat the underlying inflammation through identification of potential food triggers, the use of medication or both. Phenotypic subtypes may require different treatment approaches.

The development of this information was made possible through support from Sanofi and Regeneron.