TITLE

Eosinophilic Esophagitis: Is It All Allergies?

AUTHOR(S)
Swoger, Jason M.; Weller, Catherine R.; Arora, Amindra S.
PUB. DATE
December 2007
SOURCE
Mayo Clinic Proceedings;Dec2007, Vol. 82 Issue 12, p1541
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Eosinophilic esophagitis (EE) is an increasingly recognized disorder in the adult population, most often manifested by symptoms of dysphagia and food impaction. Mechanisms involving eotaxin-3, interleukin 5, and signal transducer and activator of transcription 6 have been studied and may represent future therapeutic targets. Patients commonly have a personal and family history of atopy, and both food allergies and aeroallergens have also been investigated as triggers of EE. Traditional allergy-testing methods, including skin prick testing and specific IgE testing, have been used to identify food and environmental allergies. However, new studies suggest that patch testing could add to diagnostic accuracy in EE because the disorder might not be a classic type I allergic response. Although studies of treatment of adults with EE have thus far focused on swallowed fluticasone proprionate, many trials in children have assessed the efficacy of food elimination and elemental diets. These diets, which have been extremely successful in reducing symptoms, have also been shown to induce histological improvement and remission. No similar studies have been conducted in adults; the tolerability of such an intervention may prove more difficult in this population. This article reviews the underlying pathophysiology of EE and describes evolving options for more accurately identifying food and environmental allergies. We also discuss the pediatric trials using food elimination and avoidance diets and suggest that this type of intervention may be an important area of future research in the adult population.
ACCESSION #
27828561

 

Related Articles

  • Eosinophilic Esophagitis. Moawad, Fouad J.; Veerappan, Ganesh R.; Wong, Roy K. // Digestive Diseases & Sciences;Sep2009, Vol. 54 Issue 9, p1818 

    Eosinophilic esophagitis is a chronic inflammatory disorder characterized by dense eosinophilic infiltration of the esophageal mucosa. The pathogenesis is incompletely understood and food allergies and aeroallergens have been implicated. The most common clinical presentation in adults is...

  • Reoperative Fundoplications Are Effective Treatment for Dysphagia and Recurrent Gastroesophageal Reflux. Rosemurgy, Alexander S.; Arnaoutakis, Dean J.; Thometz, Donald P.; Binitie, Odion; Giarelli, Natalie B.; Bloomston, Mark; Goldin, Steve G.; Albrink, Michael H. // American Surgeon;Dec2004, Vol. 70 Issue 12, p1061 

    With wide application of antireflux surgery, reoperations for failed fundoplications are increasingly seen. This study was undertaken to document outcomes after reoperative fundoplications. Sixty-four patients, 26 men and 38 women, of average age 55 years ± 15.6 (SD), underwent reoperative...

  • A Tale of Two Peptic Strictures: Esophageal and Duodenal. Triadafilopoulos, George; Raju, Jagjit S.; Kieturakis, Maciej J. // Digestive Diseases & Sciences;May2010, Vol. 55 Issue 5, p1251 

    The article presents a case study of a 33-year-old Indian man presented for management of known gastroesophageal reflux disease (GERD) with a resistant esophageal stricture and dysphagia in August 2008. He had been diagnosed with heartburn and dysphagia in November 2007 due to heavy drinking and...

  • Reoperative laparoscopic paraesophageal herniorrhaphy can produce excellent outcomes. Tsang, Albert W.; Tiwari, Manish M.; Reynoso, Jason F.; Okwuosa, Chris U.; Oleynikov, Dmitry // Surgical Endoscopy;May2011, Vol. 25 Issue 5, p1458 

    Background: Patients undergoing laparoscopic paraesophageal herniorrhaphy present with various esophageal and extraesophageal symptoms. Given a recurrence rate of up to 44%, reoperative intervention is necessary on a number of patients. The goal of this study is to determine whether patients...

  • Clinical, Radiological, and Manometric Profile in 145 Patients with Untreated Achalasia. Fisichella, Piero M.; Raz, Dan; Palazzo, Francesco; Niponmick, Ian; Patti, Marco G. // World Journal of Surgery;Sep2008, Vol. 32 Issue 9, p1974 

    Esophageal achalasia is characterized by the absence of esophageal peristalsis and by a dysfunctional lower esophageal sphincter (LES). Descriptions of clinical, radiological, and manometric findings in patients with achalasia usually have been based on small numbers of patients. This study was...

  • ESOPHAGEAL LICHEN PLANUS: A CASE REPORT AND REVIEW OF LITERATURE. Madhusudhan, K. S.; Sharma, Raju // Indian Journal of Dermatology;Jan-Mar2008, Vol. 53 Issue 1, p26 

    Lichen planus is a rare cause of esophagitis and esophageal stricture. It is invariably associated with oral mucosal involvement and the diagnosis has to be considered in these patients who present with dysphagia. We present a case of esophageal stricture secondary to lichen planus.

  • The Lower Esophageal Ring and Esophageal Reflux. Scharschmidt, Bruce F.; Watts, H. David // American Journal of Gastroenterology;May1978, Vol. 69 Issue 5, p544 

    Although the lower esophageal ring is an important cause of dysphagia in adults, its pathogenesis is unknown. To better define the relationship between the lower esophageal ring and esophageal reflux, we analyzed, retrospectively, the records of 18 hospitalized patients with radiologically...

  • Eosinophilic esophagitis. Marcum, Kristin Kucera; Rees, Catherine J.; Mott, Ryan T. // ENT: Ear, Nose & Throat Journal;Dec2009, Vol. 88 Issue 12, p1258 

    The article focuses on eosinophilic esophagitis. The disorder, which usually presents as dysphagia, food impaction and/or a globus sensation, is said to be increasingly recognized in the adult population. A consensus panel of the American Gastroenterological Association (ASA) described the...

  • Large Epiphrenic Diverticulum. Widmar, Maria; Nguyen, Scott Q.; Newell, Philippa; Patel, Pruthvi; Divino, Celia M. // Journal of Gastrointestinal Surgery;Jun2010, Vol. 14 Issue 6, p1062 

    The article discusses the case of a 53-year-old man with intractable esophageal reflux disease (GERD) who developed large epiphrenic diverticulum (ER). The patient manifested dysphagia to solids, regurgitation of solids and liquids, and worsening reflux manifestations. Results of the computed...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics