title: Management of proton pump inhibitor responsive-esophageal eosinophilia and eosinophilic esophagitis: controversies in treatment approaches.
abstract: Eosinophilic esophagitis (EoE) is a chronic immune-mediated clinicopathologic disease. The prevalence of EoE is approximately 1/2000 persons, EoE is now the most common cause of food impactions, with healthcare expenditures approaching US$ 1 billion annually. This article will discuss challenges related to proton pump inhibitor responsive esophageal eosinophilia, including distinguishing this condition from EoE and understanding the mechanisms behind the PPI response. For EoE, we will review multiple ongoing debates about treatment and monitoring strategies, including selecting treatment outcomes, optimizing medication formulations, approaching the steroid-refractory patient, conducting dietary elimination, prescribing long-term maintenance therapy and performing esophageal dilation.
authors.affiliation: a Department of Medicine, Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
authors.forename: Bharati
authors.initials: B
authors.lastname: Kochar
authors.forename: Evan S
authors.initials: ES
authors.lastname: Dellon
mesh_terms: D003937:Diagnosis, Differential; D004032:Diet / Q000009:adverse effects; D004106:Dilatation; D004334:Drug Administration Schedule; D004802:Eosinophilia / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D057765:Eosinophilic Esophagitis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D004935:Esophageal Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D004945:Esophagoscopy; D006801:Humans; D011237:Predictive Value of Tests; D054328:Proton Pump Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012074:Remission Induction; D012307:Risk Factors; D013256:Steroids / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D054328:Proton Pump Inhibitors; D013256:Steroids
keywords: challenges; endoscopy; eosinophilic esophagitis; management; proton pump inhibitor responsive esophageal eosinophilia