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J Paediatr Child Health. 2015 May;51(5):512-514. doi: 10.1111/jpc.12757. Epub 2014 Nov 2.

Eosinophilic oesophagitis: A paediatric update.

Allen KJ1,2,3, Heine RG1,2,3.

Author information

1
Department of Allergy, Gastroenterology and Immunology, Royal Children's Hospital, Melbourne, Victoria, Australia.
2
Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.
3
Centre of Food and Allergy Research, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.

Abstract

Eosinophilic oesophagitis (EoE) is a key differential for gastro-oesophageal reflux (GOR) in children. It can be difficult for clinicians to decide which patients need referral for the assessment of EoE, which can only be confirmed by histological analysis of endoscopic biopsies. Recent guidelines recommend that EoE can only be diagnosed following the exclusion of GOR through empiric treatment with proton pump inhibitors prior to endoscopy. Some aspects of history are strongly suggestive of EoE: red flags for referral include poor weight gain in the context of reflux symptoms, choking during eating or food impaction. Therapeutic options include dietary allergen elimination or swallowed aerosolised corticosteroids. Other novel therapies have failed to demonstrate benefit, but novel diagnostic biomarkers to enable non-invasive disease ascertainment and follow-up show some promise.

KEYWORDS:

corticosteroids; elimination diet; eosinophil; gastro-oesophageal reflux disease; proton-pump inhibitor

PMID:
25363166
DOI:
10.1111/jpc.12757

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