Epidemiology
Etiology
Pathophysiology
- Chronic Th2 cell–mediated disorder triggered by food antigens
- Eosinophilic infiltration of the esophageal mucosa
Clinical features
- Adults: Intermittent solid food dysphagia, food impaction (classic presentation requiring ED visit), chest pain, refractory heartburn.
- Children: Failure to thrive, vomiting, abdominal pain, refusal to eat.
- Symptoms often persist despite PPI therapy (though PPI-responsive EoE is a subtype).
Diagnostics
Endoscopic findings
- Stacked circular rings (“Trachealization” or “Feline esophagus”).
- Linear furrows and whitish exudates/plaques.
- Strictures (late finding).
- Note: Normal mucosa does not rule out EoE.
Histopathologic findings
- Intraepithelial accumulation of eosinophils
Treatment
- First-line: Proton pump inhibitors (PPIs)