Eosinophilic oesophagitis

Question 1

what is Eosinophilic oesophagitis

Answer 1

allergic inflammation of the oesophagus

Question 2

etiology of eosinophilic esophagitis ?

Answer 2

thought to be caused by an allergic reaction to ingested food.
more predominant in males

Question 3

associations of eosinophilic esophagitis ?

Answer 3

Allergies/ asthma: suffering from food/ environmental allergies or atopic dermatitis and asthma increases the risk of diagnosis
Male sex
Family history of eosinophilic oesophagitis or allergies
Age between 30-50

Question 4

clinical features of eosinophilic esophagitis ?

Answer 4

egurgitation/ vomiting
food impaction
pain
dysphagia - stricture

Question 5

diagnosis of eosinophilic esophagitis

Answer 5

diagnosis can only be made on the histological analysis of an oesophageal biopsy THROUGH ENDOSCOPY

Histology - eosinophil infiltration
osinophilic microabscesses, and abnormally long papillae

ON endoscopy - MUCOSAL FURROWS, strictures and laryngeal oedema

PPI trail with no success

Question 6

management of EOSINOPHILIC esophagitis

Answer 6

no improvementafter trialling a proton pump inhibitor.
This can help the clinician differentiate between eosinophilic oesophagitis and GORD

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Dietary modification

fluticasone and budesonide - swallow solutions of the steroid to line the oesophagus.
done for 8 wks then reassessed

Oesophageal dilatation: 56% of patients require this at some point in their treatment to reduce the symptoms associated with oesophageal strictures

Question 7

Prognosis of eosinophilic esophagitis ?

Answer 7

chronic condition
likely to come back in patients that stop treatment so it important to gain a good balance of dietary modifications and additional pharmacological treatments when necessary.