title: Eosinophilic esophagitis: From pathophysiology to treatment.
abstract: 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.
authors.affiliation: Alessandra D'Alessandro, Marcella Pesce, Rosario Cuomo, Giovanni Sarnelli, Department of Clinical Medicine and Surgery, Gastroenterology Unit, Federico II University, 80131 Naples, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: D'Alessandro
authors.affiliation: Alessandra D'Alessandro, Marcella Pesce, Rosario Cuomo, Giovanni Sarnelli, Department of Clinical Medicine and Surgery, Gastroenterology Unit, Federico II University, 80131 Naples, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Esposito
authors.affiliation: Alessandra D'Alessandro, Marcella Pesce, Rosario Cuomo, Giovanni Sarnelli, Department of Clinical Medicine and Surgery, Gastroenterology Unit, Federico II University, 80131 Naples, Italy.
authors.forename: Marcella
authors.initials: M
authors.lastname: Pesce
authors.affiliation: Alessandra D'Alessandro, Marcella Pesce, Rosario Cuomo, Giovanni Sarnelli, Department of Clinical Medicine and Surgery, Gastroenterology Unit, Federico II University, 80131 Naples, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Cuomo
authors.affiliation: Alessandra D'Alessandro, Marcella Pesce, Rosario Cuomo, Giovanni Sarnelli, Department of Clinical Medicine and Surgery, Gastroenterology Unit, Federico II University, 80131 Naples, Italy.
authors.forename: Giovanni Domenico
authors.initials: GD
authors.lastname: De Palma
authors.affiliation: Alessandra D'Alessandro, Marcella Pesce, Rosario Cuomo, Giovanni Sarnelli, Department of Clinical Medicine and Surgery, Gastroenterology Unit, Federico II University, 80131 Naples, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Sarnelli
keywords: Endoscopic dilation; Eosinophilic esophagitis; Eotaxin; Immune system; Proton pump inhibitors-responsive eosinophilia