Eosinophilic esophagitis is a condition that is being increasingly recognized in adults.
The main presenting symptoms are dysphagia (93 %), food impaction (62 %), and heartburn
(24 %). A history of allergy is obtained in 52 % of patients and peripheral eosinophilia
is found in 31 % of patients with this condition. Esophageal manometric studies have
provided evidence of a nonspecific motility disorder in 40 % of patients. Endoscopic
findings include mucosal fragility or edema (59 %), solitary or multiple concentric
rings (49 %), strictures (40 %), whitish pinpoint exudates or papules (16 %), and
a small-caliber esophagus (5 %); 9 % of patients present with a normal endoscopy.
Esophageal dilation in adults with eosinophilic esophagitis has limited efficacy and
is associated with an increased complication rate compared with dilation in patients
with benign strictures. The administration of inhaled or systemic corticosteroids
results in symptomatic improvement in nearly 95 % of patients. A trial with corticosteroids
before bougienage may reduce active inflammation and therefore the complication rate
of the procedure.
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S. N. Sgouros, M.D. PhD
Department of Gastroenterology · Athens Naval and Veterans Hospital
Nafpaktias 5 · Agia Paraskevi · Athens · Attica · 15341 · Greece
Fax: +30-210-6080728
eMail: spisgon@otenet.gr
