Eosinophilic Esophagitis: Emerging Insights Into Diagnosis and Management.

Abstract

Eosinophilic esophagitis (EoE) is a chronic, immune-mediated, esophageal disease characterized by eosinophilic infiltration and symptoms such as dysphagia, food impaction, and esophageal dysfunction. Advances in diagnostic tools, including the EoE Endoscopic Reference Score and the Eosinophilic Esophagitis Histologic Scoring System, have improved disease characterization and monitoring. First-line treatments, such as proton pump inhibitors and topical corticosteroids, achieve significant histological and clinical remission rates. Dietary approaches, including the six-food elimination diet and step-up strategies, provide effective non-pharmacological options, although adherence remains a challenge. Esophageal dilation is a safe and effective therapy for relieving symptoms of dysphagia caused by strictures. Emerging biological therapies, such as dupilumab, show promise for targeting specific inflammatory pathways and addressing refractory cases. Although current therapies have demonstrated efficacy, gaps remain in the optimization of long-term disease control and treatment sequencing.