New guideline provides evidence-based recommendations for clinical management of EoE

Reviewed by James Ives, M.Psych. (Editor)Apr 28 2020

Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus triggered by allergens that causes difficulty with swallowing in adults, which grows more frequent and intense over time, affecting patients' quality of life. Children experience varied symptoms that include feeding difficulty, pain, vomiting, as well as dysphagia. EoE affects an estimated one in 2,000 people.

A new guideline from the American Gastroenterological Association (AGA) and the Joint Task Force for Allergy-Immunology Practice Parameters provides recommendations for the management of EoE in pediatric and adult patients.

Key guideline highlights:

• Topical steroids are recommended as a first-line treatment for EoE.
• The guideline also recommends proton pump inhibition (PPI) therapy, diet therapy and esophageal dilation as treatment options.
• The use of novel, targeted biologic therapies for EoE are being actively evaluated and more research is needed before these can be recommended.

Over the past two decades, EoE has emerged as a dominant cause of swallowing difficulties worldwide.The recommendations we've outlined will guide allergists and gastroenterologists in effectively managing their patients' EoE and improving their quality of life. As the field moves forward, a deeper understanding of the natural history of EoE in both children and adults is needed to inform clinical decisions regarding the optimal use of disease monitoring and long-term, maintenance therapy."

Ikuo Hirano, MD, AGAF, Gastroenterologist, Lead Guideline Author, Northwestern University Feinberg School of Medicine

This guideline was developed through a collaboration between AGA and the Joint Task Force for Allergy-Immunology Practice Parameters, which comprises the American Academy of Allergy, Asthma & Immunology and the American College of Allergy, Asthma & Immunology.

This guideline is jointly published in Gastroenterology, the official journal of the AGA Institute, and Annals of Allergy, Asthma and Immunology, the scientific journal of the American College of Allergy, Asthma & Immunology.