Idiopathic eosinophilic oesophagitis is an inflammatory disease of the oesophagus characterised by eosinophilia that can involve all the layers of the oesophagus.
It is most commonly seen in males aged 20-40. It is an uncommon disease; however not rare.
Patients typically present with dysphagia or with food stuck in the oesophagus. Usually a specific food or allergen triggers the presentation, and symptoms may persist for a long time afterwards.
The exact aetiology is unknown. Exposure to a food or allergen triggers the activation of eosinophils within the oesophageal wall and a consequent inflammatory cascade ensues.
Oesophageal strictures, webs and spasm cause the presentation of food impaction.
- 'ringed' oesophagus: concentric, ring-like strictures of the oesophagus on a barium swallow
- these ring-like strictures may co-exist with longer strictures, and may be associated with oesophageal spasm, dysmotility and foreshortening
- non-specific oesophageal submucosal oedema
Treatment and prognosis
It is self-limiting in some cases, but responds well to oral glucocorticoid therapy. It may lead to retardation of growth in some children.
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