Eosinophilic Esophagitis

Hörning A, Steiß JO, Madisch A, de Laffolie J (2025)

Publication Language: English

Publication Type: Journal article, Review article

Publication year: 2025

Journal

Deutsches Ärzteblatt international Deutscher Ärzte-Verlag

Book Volume: 122

Pages Range: 195-201

Journal Issue: 7

DOI: 10.3238/arztebl.m2025.0042

Abstract

Background: Eosinophilic esophagitis is a chronic, Th2 immune–mediated disease of the esophagus characterized by esophageal dysfunction and predominant eosinophilic inflammation. Its prevalence and incidence have risen in recent years and now stand at 16.1 per 100 000 persons and 1.7 per 100 000 persons per year. Methods: This review is based on selected publications retrieved by a search in PubMed, Medline, and Google Scholar for clinical trials, reviews, and guidelines that were published between 2011 and 2024 in either English or German (search term, “eosinophilic esophagitis”). Results: Eosinophilic esophagitis markedly impairs patients’ quality of life; its diagnosis is often delayed. It can be treated with an appropriately altered diet, pharmacotherapy, and/or endoscopic intervention (“diet, drugs, dilatation”). Elimination diets with the omission of 2, 4, or 6 food groups lead to histological remission in 43%, 60%, and 79% of patients, respectively. An entirely amino acid–based diet leads to histological remission in over 90% of patients, but can only be performed for a limited time. Topical corticosteroids lead to histological remission in 60–87% of cases, proton-pump inhibitors in 30–50%, and dupilumab (anti-IL-4Rα/IL-13Rα1) in 60–86%. These treatments differ widely in their side-effect profiles and in the restrictions they impose in everyday life, and their use must be considered individually for each patient. Because eosinophilic esophagitis is a chronic disease, remission maintenance therapy is needed over the long term. Conclusion: Eosinophilic esophagitis was first described three decades ago. Effective treatments are available, but questions remain concerning the long-term course of the disease, remission maintenance therapy, and non-invasive markers of disease activity, among others. Delays in diagnosis should be avoided. The appropriate treatment and long-term care of the affected patients are needed to assure them an optimal quality of life.

Authors with CRIS profile

André Hörning Department of Paediatrics and Adolescent Medicine

Involved external institutions

Universitätsklinikum Gießen und Marburg (UKGM) DE Germany (DE) Krankenhaus Diakovere Friederikenstift Hannover DE Germany (DE)

How to cite

APA:

Hörning, A., Steiß, J.-O., Madisch, A., & de Laffolie, J. (2025). Eosinophilic Esophagitis. Deutsches Ärzteblatt international, 122(7), 195-201. https://doi.org/10.3238/arztebl.m2025.0042

MLA:

Hörning, André, et al. "Eosinophilic Esophagitis." Deutsches Ärzteblatt international 122.7 (2025): 195-201.

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