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Translating New Developments in Eosinophilic Esophagitis Pathogenesis into Clinical Practice

  • Esophagus (E Dellon, Section Editor)
  • Published:
Current Treatment Options in Gastroenterology Aims and scope Submit manuscript

Opinion statement

New developments in eosinophilic esophagitis (EoE) pathogenesis are shaping our current therapeutic and management strategies. EoE is a chronic allergic inflammatory disease with progression to fibrostenotic disease. The disease warrants early diagnosis and long-term maintenance therapy. The diagnosis of EoE should be based on the concept of an allergy-mediated disease with esophageal dysfunction and esophageal eosinophilia. Recent findings suggest that proton pump inhibitor (PPI)-responsive esophageal eosinophilia (PPI-REE) is likely a continuum of EoE or a similar T-helper 2 (Th2)-mediated allergic process. PPIs have therapeutic properties that can benefit both gastroesophageal reflux disease (GERD) and EoE. Therefore, PPIs should be considered not a diagnostic tool but, rather, a therapeutic option for EoE. If patients are PPI nonresponsive, then dietary therapy or steroid therapy should be considered. Dilation can be reserved as adjuvant therapy for severe fibrostenotic lesions.

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Conflict of Interest

Edaire Cheng has received the following grants: American Gastroenterological Association Fellows to Faculty Transition Award, National Institutes of Health (NIH) grant number K12 HD068369-02, NASPGHAN/AstraZeneca Award for Disorders of the Upper GI Tract, American Gastroenterological Association Research Scholar Award, and NIH grant number K08 DK099383-01. Dr. Cheng has also received honoraria from the American Gastroenterological Association.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Esophageal Diseases Center, Pediatric Gastroenterology, Department of Pediatrics, Children’s Medical Center and the University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA

    Edaire Cheng MD

  2. Esophageal Diseases Center, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Edaire Cheng MD

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  1. Edaire Cheng MD
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Correspondence to Edaire Cheng MD.

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This article is part of the Topical Collection on Esophagus

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Cheng, E. Translating New Developments in Eosinophilic Esophagitis Pathogenesis into Clinical Practice. Curr Treat Options Gastro 13, 30–46 (2015). https://doi.org/10.1007/s11938-014-0041-8

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