Eosinophilic Esophagitis: Interactions with Gastroesophageal Reflux Disease

Kumar Krishnan*, Ikuo Hirano

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Eosinophilic esophagitis is a chronic immune/antigen-mediated esophageal disease characterized by the presence of symptoms of esophageal dysfunction, primarily dysphagia in adults, combined with histological evidence of eosinophil-predominant inflammation. The histopathological findings of increased esophageal eosinophilia are not specific for eosinophilic esophagitis and have been described in a number of infectious and inflammatory esophageal disorders. Moreover, there is significant overlap in the symptoms and histology between eosinophilic esophagitis and gastroesophageal reflux disease. The relationship between eosinophilic esophagitis and gastroesophageal reflux disease has been the source of recent investigation. Proton pump inhibition may reverse elevated esophageal eosinophilia in a subset of patients suspected of having eosinophilic esophagitis, even in the absence of other objective evidence of gastroesophageal reflux disease (erosive esophagitis, abnormal pH testing). It is unclear at this time whether the response to PPI is truly diagnostic for gastroesophageal reflux disease or perhaps indicative of a proton pump inhibitor-responsive form of eosinophilic esophagitis. In this chapter, the challenges in diagnosing eosinophilic esophagitis and the difficulties in distinguishing it from gastroesophageal reflux disease are reviewed.

Original languageEnglish (US)
Title of host publicationPractical Manual of Gastroesophageal Reflux Disease
PublisherJohn Wiley and Sons
Pages253-266
Number of pages14
ISBN (Print)9780470656266
DOIs
StatePublished - Jan 25 2013

Keywords

  • Dysphagia
  • Eosinophilic esophagitis
  • Gastroesophageal reflux disease

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Krishnan, K., & Hirano, I. (2013). Eosinophilic Esophagitis: Interactions with Gastroesophageal Reflux Disease. In Practical Manual of Gastroesophageal Reflux Disease (pp. 253-266). John Wiley and Sons. https://doi.org/10.1002/9781118444788.ch15