Eosinophilic Esophagitis

Eosinophilic esophagitis is a chronic autoimmune disease of the esophagus, leading to an eosinophil-dominant inflammation of the esophagus; this can cause reflux-like symptoms, dysphagia and pinching of food.

Eosinophilic esophagitis is a chronic autoimmune disease of the esophagus, leading to an eosinophil-dominant inflammation of the esophagus; this can cause reflux-like symptoms, dysphagia and pinching of food.

(P a.Übersicht to esophageal dysphagia) Eosinophilic esophagitis is a chronic autoimmune disease of the esophagus, leading to an eosinophil-dominant inflammation of the esophagus; this can cause reflux-like symptoms, dysphagia and pinching of food. (. See also the American College of Gastroenterology’s evidenced-based approach to the Diagnosis and Management of Esophageal eosinophilia and Eosinophilic esophagitis (EoE)) Eosinophilic esophagitis is an increasingly recognized disease that can begin at any time between childhood and young adulthood; sometimes it manifests itself in older adults. In men, it is more common. The cause is probably an immune response to food antigens in patients with genetic susceptibility; Environmental allergens may also play a role. The untreated chronic esophageal inflammation can eventually lead to esophageal narrowing and stenosis. Symptoms infants and children can imagine with food refusal, vomiting and / or chest pain. In adults, the oesophageal Speiseimpaktion is sometimes the first manifestation, and most patients have dysphagia. Symptoms of gastroesophageal reflux disease (GERD), as heartburn can occur. Patients often also have other manifestations of atopic diseases (eg., Asthma, eczema, allergic rhinitis). Diagnostic endoscopy with biopsy Occasionally, barium swallow The diagnosis of eosinophilic esophagitis is often taken into account for the first time when the reflux symptoms do not improve by an inhibition of acid secretion. They should be considered in adults who present with esophageal Speiseimpaktion, or in adults with non-cardiac chest pain. For diagnosing an endoscopy with biopsy with evidence of eosinophilic infiltration is required (> 15 eosinophilic / powerful field). Although visible changes can be seen during endoscopy (z. B. furrows strictures and rings), the appearance may be normal, so biopsies are essential. Because GERD can also cause eosinophilic infiltrates, should in patients who show above all a reflux symptoms, endoscopy will likely be carried out only after an unsuccessful two-month therapeutic trial with a proton pump inhibitor. A esophagram can show a feline esophagus, ringed esophagus, narrow caliber esophagus or strictures. A test for food allergies is often performed to identify possible triggers; Alternatives are skin tests Radioallergosorbent test (RAST) or exclusion diet. Topical corticosteroids therapy Sometimes esophageal dilatation In adults they are often given exclusion diet for the treatment of eosinophilic esophagitis. Patients can (220 mcg) or budesonide use a Mehrfachdosisinhalator with fluticasone (180 mcg) 30 minutes before breakfast and 30 minutes before dinner; they blow the drug in the mouth without inhaling and then swallow it. Budesonide (0.5 mg / 2 ml mixed with a sugar substitute and swallowed 30 minutes before breakfast and 30 minutes before dinner) can be mixed in a suspension and swallowed. They are given over 8 weeks. Dietary modifications are also tried and are more effective than in adults usually in children; Food allergens that have been identified using tests are omitted, or the patient follow a predefined exclusion diet (see Table: Permissible foods in elimination diets *). Patients with significant stenoses may require a cautious esophageal dilatation with a balloon or Ösophagusdilatator; more carefully conducted, progressive dilations are performed to prevent oesophageal cracks or perforation. For more information evidenced based approach to the diagnosis and management of esophageal eosinophilia and eosinophilic esophagitis (EoE) of the American College of Gastroenterology

Health Life Media Team

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