Editor's Choice
Eosinophilic esophagitis (EoE) is a chronic, immune-mediated inflammatory disease of the esophagus commonly complicated by and presenting as esophageal food impaction (EFI). In many studies, EoE is the most common cause of EFI in patients presenting to the emergency department (ED) Despite the increasing disease burden of EoE, EoE-related EFI, and risks of EFI few studies have identified best practices for management of EFI in patients with established or suspected EoE.
EoE-related EFI poses several important considerations. First, EFI may represent the initial presentation of EoE and should raise a high index of suspicion for this diagnosis. Second, EoE-related EFI can occur in the setting of active mucosal inflammation or chronic remodeling and stricture each of which requires a different therapeutic approach. Third, because EoE is a chronic condition, disimpaction may have been performed previously and, consequently, approaches may vary based on prior outcomes with dilation. Each of these factors may influence care before, during and after endoscopic assessment and treatment.
