Management of Eosinophilic Esophagitis
Management of Eosinophilic Esophagitis
There is still significant scope for improving the diagnostic methods and treatment options for EO. Diagnosis currently depends on endoscopy and biopsy, which may need to be repeated to monitor the therapeutic response. Furthermore, even with endoscopy discrimination from GORD is not always straightforward, particularly, since PPI therapy can significantly influence the histological findings. There is thus a need for non-invasive tests for diagnosis and disease monitoring. A recent study, which measured eosinophil-derived proteins in luminal secretions to distinguish between EO and GORD, is a promising step in this direction. Treatment options are also unfortunately limited. If an exclusion diet is not successful, or causative foods cannot be identified, then long-term elemental feeding or corticosteroid therapy may become necessary. The development of effective alternative therapy is thus a priority, particularly since progression to fibrosis/stricture formation is not an uncommon outcome.
Conclusion
There is still significant scope for improving the diagnostic methods and treatment options for EO. Diagnosis currently depends on endoscopy and biopsy, which may need to be repeated to monitor the therapeutic response. Furthermore, even with endoscopy discrimination from GORD is not always straightforward, particularly, since PPI therapy can significantly influence the histological findings. There is thus a need for non-invasive tests for diagnosis and disease monitoring. A recent study, which measured eosinophil-derived proteins in luminal secretions to distinguish between EO and GORD, is a promising step in this direction. Treatment options are also unfortunately limited. If an exclusion diet is not successful, or causative foods cannot be identified, then long-term elemental feeding or corticosteroid therapy may become necessary. The development of effective alternative therapy is thus a priority, particularly since progression to fibrosis/stricture formation is not an uncommon outcome.
