Eosinophilic Esophagitis: Review and Update

Background: Eosinophilic esophagitis is a chronic, antigen-mediated disease of the esophagus that causes dysphagia and swallowing in adults, with nonspecific symptoms of esophageal dysfunction and/or alterations in swallowing in children, and sometimes with esophageal stenosis in both unless treatment is prescribed. Characteristics. EoE courses with symptoms of esophageal dysfunction, especially in adults, such as dysphagia and choking. In children, esophageal symptoms are more nonspecific and also involve alterations in swallowing. In addition, they are necessary for the diagnosis of ≥15 eosinophils per field of large increase in at least one biopsy of the esophagus, and other causes of esophageal eosinophilia must be ruled out. Treatment can be with food elimination diets (elementary, empirical, or according to allergy tests), or pharmacological (proton pump inhibitor drugs, deglutidated topical corticoids, and dupilumab). When there is esophageal stenosis, the treatment would be esophageal dilatation. Objetives: This review offers a general and practical overview of the recent literature on EoE (epidemiology, etiopathogeny, pathophysiology, diagnosis, prognosis, and treatment). Methods: The team performed a bibliographic search on PubMed between February -2019 tJune-2025. Keywords used in the search: eosinophilic esophagitis, epidemiology, etiopathogeny, pathophysiology, symptoms, diagnosis, natural history, prognosis, therapy/treatment. In total we use reviewed 100 articles on EoE for the preparation of this review and update. Results: This review provides an updated and comprehensive overview of multiple aspects of eosinophilic esophagitis, as outlined in the study objectives. Each characteristic was analyzed in light of the most recent evidence to reflect current understanding and clinical practice. Conclusions: Primary eosinophilic gastrointestinal disease affecting the esophagus exclusively, characterized by chronic, antigen-triggered inflammation. Symptoms vary depending on whether they are children or adults. Diagnosis is made by esophageal symptoms and/or alterations in swallowing and ≥15 eosinophils /HPF in at least one of the esophageal biopsies, after ruling out other causes of esophageal eosinophilia. Complications can arise if patients are undiagnosed and untreated, both in the short and long term. EoE is frequently associated with atopic comorbidities. They also tend to have digestive comorbidities, although to a lesser extent. Autoimmune and other connective tissue diseases are not relevant. Treatment may be with food elimination diets or with drugs, and to assess the response to the same is t