Idiopathic eosinophilic esophagitis

Last revised by Dr Henry Knipe on 10 Feb 2019

Idiopathic eosinophilic esophagitis is an inflammatory disease of the esophagus characterized by eosinophilia that can involve all the layers of the esophagus

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 esophagus. Usually, a specific food or allergen triggers the presentation, and symptoms may persist for a long time afterwards. 

The exact etiology is unknown. Exposure to food or allergen triggers the activation of eosinophils within the esophageal wall and a consequent inflammatory cascade ensues.

Esophageal strictures, webs and spasm cause the presentation of food impaction.

  • 'ringed' esophagus: concentric, ring-like strictures of the esophagus on a barium swallow
  • these ring-like strictures may co-exist with longer strictures and may be associated with esophageal spasm, dysmotility and foreshortening
  • non-specific esophageal submucosal edema

It is self-limiting in some cases but responds well to oral glucocorticoid therapy. It may lead to growth retardation in some children.

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Cases and figures

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  • Case 1
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