Idiopathic eosinophilic oesophagitis is an inflammatory disease of the oesophagus characterised by eosinophilia that can involve all the layers of the oesophagus.
On this page:
Epidemiology
It is most commonly seen in males aged 20-40. It is an uncommon disease; however not rare.
Clinical presentation
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.
Pathology
The exact aetiology is unknown. Exposure to 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.
Radiographic features
Fluoroscopy
'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
CT
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 growth restriction/delay in some children.
Differential diagnosis
gastro-oesophageal reflux, especially if the feline oesophagus is present
intestinal parasitic infestation
drug-induced oesophagitis
Unable to process the form. Check for errors and try again.