Pediatric Eosinophilic Esophagitis: Epidemiology, Diagnosis and Treatment

Eosinophilic esophagitis (EoE) is a disease based on a clinico-pathologic diagnosis which involves a localized eosinophilic inflammation of the esophagus. There has been a significant increase in the incidence of diagnosis of pediatric EoE over the past 10 years due, in part, to a greater recognition of the disease among gastroenterologists, allergists and pathologists. EoE is defined by the presence of 15 or more eosinophils per high-powered field on esophagastroduodenoscopic biopsies isolated to the esophagus associated with characteristic clinical symptoms which do not respond to gastric acid-blockade. While the exact mechanism of EoE is unknown, food allergens are thought to play a significant role. When available, a combination of skin prick and atopy patch testing may be useful when attempting to identify IgE and non-IgE based food allergens in patients with EoE. Effective treatment options include dietary restrictions and various steroid formulations. A multidisciplinary approach is essential for a timely diagnosis and successful treatment strategies in patients with EoE.