Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus triggered by allergens that causes difficulty with swallowing in adults, which grows more frequent and intense over time, affecting patients' quality of life. Children experience varied symptoms that include feeding difficulty, pain, vomiting, as well as difficulty swallowing. EoE affects an estimated one in 2,000 people.
A new guideline from the American Gastroenterological Association (AGA) and the Joint Task Force for Allergy-Immunology Practice Parameters provides recommendations for the management of EoE in pediatric and adult patients.
Key guideline highlights:
- Topical steroids(such as swallowed Flovent or budesonide) are recommended as a first-line treatment for EoE.
- The guideline also recommends proton pump inhibition (PPI) therapy (such as omeprazole and lansoprazole,) diet therapy and esophageal dilation as treatment options.
- The use of novel, targeted biologic therapies for EoE are being actively evaluated and more research is needed before these can be recommended.
"Over the past two decades, EoE has emerged as a dominant cause of swallowing difficulties worldwide," said Ikuo Hirano, MD, AGAF, a gastroenterologist from Northwestern University Feinberg School of Medicine, Chicago, Illinois, and lead guideline author. "The recommendations we've outlined will guide allergists and gastroenterologists in effectively managing their patients' EoE and improving their quality of life. As the field moves forward, a deeper understanding of the natural history of EoE in both children and adults is needed to inform clinical decisions regarding the optimal use of disease monitoring and long-term, maintenance therapy."
This guideline was developed through a collaboration between AGA and the Joint Task Force for Allergy-Immunology Practice Parameters, which comprises the American Academy of Allergy, Asthma & Immunology and the American College of Allergy, Asthma & Immunology. This guideline is jointly published in Gastroenterology, the official journal of the AGA Institute, and Annals of Allergy, Asthma and Immunology, the scientific journal of the American College of Allergy, Asthma & Immunology.
Review the guideline https://www.gastrojournal.org/article/S0016-5085(20)30265-1/fulltext for the complete recommendations.
WHAT IS EOSINOPHILIC ESOPHAGITIS?
EoE is a chronic inflammatory disease of the esophagus triggered by food and environmental allergens. Patients with EoE experience difficulty swallowing, vomiting and pain, potentially resulting in poor eating and growth among infants and toddlers. In children and adults with EoE, solid food can get stuck in a narrowing esophagus, increasing the risk of emergency room visits for the removal of trapped food. EoE is a recently recognized disease with increasing prevalence. EoE affects an estimated one in 2,000 people. Treatment focuses on alleviating both symptoms and esophageal inflammation while helping people maintain their quality of life.