Management of Eosinophilic Esophagitis: Dietary and Nondietary Approaches
| Autor: | Joan W. Chen |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Abdominal pain 030309 nutrition & dietetics medicine.drug_class Administration Topical Medicine (miscellaneous) Proton-pump inhibitor Constriction Pathologic Gastroenterology 03 medical and health sciences 0302 clinical medicine Adrenal Cortex Hormones Internal medicine Elimination diet Prevalence medicine Humans Child Eosinophilic esophagitis Adverse effect Food Formulated 0303 health sciences Nutrition and Dietetics business.industry Proton Pump Inhibitors Eosinophilic Esophagitis medicine.disease Dilatation Dysphagia Diet Nutrition Assessment Failure to thrive Quality of Life Vomiting Female 030211 gastroenterology & hepatology Esophagoscopy medicine.symptom business |
| Zdroj: | Nutrition in Clinical Practice. 35:835-847 |
| ISSN: | 1941-2452 0884-5336 |
| Popis: | Eosinophilic esophagitis (EoE) is an allergen-driven chronic inflammatory condition, characterized by symptoms related to esophageal dysfunction and confirmed histologically by esophageal mucosal eosinophilia. Since its first description in the 1990s, the incidence and prevalence of EoE have been on the rise. It is known to affect all ages of various ethnic backgrounds and both sexes; however, it is most seen in White males. Children with EoE often present with abdominal pain, nausea, vomiting, and failure to thrive, whereas adults with EoE typically present with dysphagia and food impaction. Diagnosis of EoE requires histologic confirmation of elevated esophageal eosinophils in a symptomatic patient, and only after secondary causes have been excluded. Because EoE is a chronic and progressively fibrostenotic disease, treatment goals include resolution of symptoms, induction and maintenance of disease remission, and prevention and possibly reversal of fibrostenotic complications, while minimizing treatment-related adverse effects and improving quality of life. Treatment strategies include the "3 D's"-drugs, diet, and dilation. Standard drug therapies include proton-pump inhibitors and topical corticosteroids. Dietary therapies include elemental diet, allergy testing-directed elimination diet, and empiric elimination diets. Endoscopic esophageal dilation for EoE strictures can alleviate esophageal symptoms but has no effect on mucosal inflammation. Recent progress in EoE research has made possible evidence-based clinical guidelines. Ongoing pharmacologic trials show promise for novel biologic agents in the treatment of refractory EoE. |
| Databáze: | OpenAIRE |
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