Eosinophilic oesophagitis (EoE) is a disease identified just over 30 years ago. The main symptom is dysphagia. EoE is initially inflammatory and progresses to fibrosis. There are differences in clinical presentation between young children and adults. Diagnosis is by endoscopy and six biopsies at varying positions of the oesophageal lining. Blood tests are of no diagnostic value as the condition is mediated by IgG4 local mucosal pathology. Endoscopic signs are distinct from those of gastro-oesophageal reflux. Histological signs of EoE are >15 eosinophils/high-power field on a background of hyperplastic mucosa. Options of therapy include diet restriction, proton pump inhibitors therapy and topical steroids but there is a dearth of randomised control trials to define the optimum approach. The only licenced therapy for EoE is budesonide orodispersible tablet, a specific formulation for oesophageal topical steroid therapy. EoE is the most common cause of spontaneous perforation in the oesophagus. Stricture formation occurs in up to 10% and may require therapeutic dilatation.

中文翻译：

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嗜酸性食管炎：最新进展和实际治疗

嗜酸性粒细胞性食管炎 (EoE) 是 30 多年前发现的一种疾病。主要症状是吞咽困难。EoE 最初是炎症性的，然后发展为纤维化。幼儿和成人的临床表现存在差异。诊断是通过内窥镜检查和在食管内壁不同位置进行的六次活检。血液检查没有诊断价值，因为该病症是由 IgG4 局部粘膜病理介导的。内镜征象不同于胃食管反流征。EoE 的组织学体征是在增生的黏膜背景上 >15 个嗜酸性粒细胞/高倍视野。治疗选择包括饮食限制、质子泵抑制剂治疗和局部类固醇治疗，但缺乏随机对照试验来确定最佳方法。EoE 唯一获得许可的治疗方法是布地奈德口腔分散片，这是一种用于食管局部类固醇治疗的特定制剂。EoE 是食管自发性穿孔的最常见原因。狭窄形成的发生率高达 10%，可能需要治疗性扩张。