Eosinophilic esophagitis (EoE) is a chronic
immune disease, characterized by a dense eosinophilic infiltrate in the esophagus, leading to bolus impaction and reflux-like symptoms. Traditionally considered a pediatric disease, the number of adult patients with EoE is continuously increasing, with a relatively higher incidence in western countries.
Dysphagia and food impaction represent the main symptoms complained by patients, but
gastroesophageal reflux-like symptoms may also be present. Esophageal biopsies are mandatory for the diagnosis of EoE, though clinical manifestations and
proton pump inhibitors responsiveness must be taken into consideration. The higher prevalence of EoE in patients suffering from atopic diseases suggests a common background with
allergy, however both the etiology and pathophysiology are not completely understood. Elimination diets are considered the first-line
therapy in children, but this approach appears less effective in adults patients, who often require
steroids; despite medical treatments, EoE is complicated in some cases by
esophageal stricture and
stenosis, that require additional endoscopic treatments. This review summarizes the evidence on EoE pathophysiology and illustrates the safety and efficacy of the most recent medical and endoscopic treatments.