Eosinophilic esophagitis: interactions with gastroesophageal reflux disease

Gastroenterol Clin North Am. 2014 Jun;43(2):243-56. doi: 10.1016/j.gtc.2014.02.004. Epub 2014 Mar 24.

Abstract

Gastroesophageal reflux disease (GERD) and eosinophilic esophagitis (EoE) are not mutually exclusive. The notion that GERD and EoE can be distinguished by the response to proton pump inhibitor (PPI) treatment is based on the mistaken assumption that gastric acid suppression is the only important therapeutic effect of PPIs, and therefore only GERD can respond to PPIs. We believe that a clinical or histologic response to PPIs does not rule in GERD or rule out EoE. We recommend a trial of PPI therapy for patients with symptomatic esophageal eosinophilia, even if the diagnosis of EoE seems clear-cut.

Keywords: Eosinophilic esophagitis; Gastroesophageal reflux disease; PPI-responsive esophageal eosinophilia; Proton pump inhibitors.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Eosinophilic Esophagitis / complications*
  • Eosinophilic Esophagitis / drug therapy
  • Gastroesophageal Reflux / complications*
  • Humans
  • Proton Pump Inhibitors / therapeutic use

Substances

  • Proton Pump Inhibitors