WHAT IS EOSINOPHILIC OESOPHAGITIS?
Eosinophilic oesophagitis (EoE) is a chronic inflammatory disease of the oesophagus, characterised by frequent vomiting, difficulties in swallowing (dysphagia), difficulties in eating and drinking, and abdominal pain. From a biopsy, an infiltration of the epithelium by white blood cells (eosinophils) is observed. Eosinophils are key cells in the innate immune system of the gastrointestinal tract. They protect the organism against parasitic infections and are usually present throughout the entire gastrointestinal tract, with the exception of the oesophagus.
Eosinophilic oesophagitis is a rare cause of dysphagia, but its prevalence is unknown.
HOW IS THIS PATHOLOGY DIAGNOSED?
The disease often evolves over several years before being diagnosed. This delay in diagnosis is mainly due to adaptation by the subject, who will create strategies to eat more slowly, chew foods well and use liquids to aid in swallowing food.
The reasons for seeking medical advice and the main complaints are difficulties in swallowing solids, food bolus impaction or gastro-oesophageal reflux symptoms.
The diagnosis of eosinophilic oesophagitis is suspected based on clinical or endoscopic information and is confirmed with oesophageal biopsies. Infiltration of the oesophageal mucosa by eosinophils is a mandatory symptom for making the diagnosis; however, it alone is not sufficient to define the disease.
WHAT IS THE TREATMENT?
The therapeutic objective is to obtain clinical and histological remission. Histological remission would in particular enable a decrease in the risk of evolution towards stenosis. First-line therapy is based on proton pump inhibitors, which help to relieve the symptoms and reduce inflammation in approximately 40% of patients.
In case of failure, treatment is based on swallowed topical steroids, but instructions for use must be clearly explained to the patient.
Dietary therapy can also help obtain clinical and histological remission in approximately 75% of cases.