Eosinophilic esophagitis (EoE) is a chronic, allergic disease of the esophagus characterized clinically by symptoms of esophageal dysfunction (including vomiting, dysphagia, feeding disorders, food impaction and abdominal pain) which persist after treatment with proton pump inhibitors (PPIs).
The current prevalence is estimated at 1/2,300-1/1,750 worldwide and appears to be on the increase. It is a predominantly male disorder.
Most cases present in children and young adults, but EoE can occur at any age. Infants and toddlers manifest with food refusal, vomiting, choking with meals and in rare cases, failure to thrive. School-aged children most commonly present with dysphagia, choking/gagging with meals, food impactions and, less commonly, regurgitation, vomiting, and chest/abdominal pain. Adults manifest mainly with dysphagia as well as food avoidance, food impactions and intractable heartburn. Symptoms may be chronic or intermittent, with some patients being completely asymptomatic during long periods. Overall, symptoms may persist up to 4 -5 years before a diagnosis is reached. In 75% of cases, there is a personal or family history of other atopic diseases (i.e. dermatitis, rhinitis, asthma).