EoE Review Emphasizes Early Diagnosis, Multimodal Monitoring
A recent narrative review highlights the evolving clinical approach to eosinophilic esophagitis (EoE), emphasizing the importance of early diagnosis, standardized assessment tools, and multimodal treatment strategies tailored to disease phenotype and regional resource constraints.
The increasing prevalence of EoE has positioned it as a major cause of dysphagia and food impaction, particularly in Western countries.
The review, which surveyed current literature and consensus guidelines through May 2025, reinforces that EoE diagnosis relies on a combination of clinical symptoms, endoscopic evaluation, and histologic confirmation. Validated tools such as the Eosinophilic Esophagitis Endoscopic Reference Score (EREFS) and the EoE Histologic Scoring System (EoEHSS) are recommended to improve diagnostic accuracy.
“Symptoms alone do not reliably reflect inflammatory activity,” the authors noted, underscoring the need for objective measures in disease monitoring.
First-line treatment options include proton pump inhibitors, swallowed topical corticosteroids, and empiric or allergy-testing–guided elimination diets. In patients with fibrostenotic disease, endoscopic dilation is considered both safe and effective. The advent of biologic therapy, particularly dupilumab, has further expanded options for patients with refractory EoE or contraindications to traditional therapy.
“The introduction of biologic agents has expanded therapeutic strategies for patients with refractory disease,” the authors wrote, while also calling attention to regional limitations in drug access and affordability.
The review stresses the need for long-term follow-up that incorporates clinical, endoscopic, and histologic assessments, rather than relying solely on symptom resolution.
Key barriers identified in the Latin American context include limited availability of specific therapies, the lack of reliable noninvasive biomarkers, and cost-effective monitoring tools. The authors conclude that “EoE is a chronic condition that requires early diagnosis and comprehensive management,” and call for future research focused on addressing these regional and global gaps in care.
Reference
Arenas-Martínez JS, Horsley-Silva JL, Vela MF. Diagnóstico y tratamiento de la esofagitis eosinofílica [Diagnosis and Treatment of Eosinophilic Esophagitis]. Acta Gastroenterol Latinoam. Published online September 30, 2025. doi:10.52787/agl.v55i3.539
