Clinical meaning
Eosinophilic Esophagitis involves pathological processes affecting GI mucosal integrity, motility, secretion, absorption, or hepatobiliary function. Eosinophilic Esophagitis pathophysiology includes epithelial barrier disruption, inflammatory cascades (TNF-alpha, IL-1, IL-6), microbiome dysbiosis, and enteric nervous system dysfunction.
Diagnosis & workup
Diagnostics & workup: - Stool studies: calprotectin, C. diff toxin, O&P, culture - Lipase (preferred over amylase for pancreatic evaluation) - H. pylori testing: urea breath test, stool antigen, or biopsy - HIDA scan for acute cholecystitis (ejection fraction <35% abnormal) - Anti-tTG IgA with total IgA for celiac disease screening - Abdominal X-ray: obstruction, free air, calcifications - FibroScan or FIB-4 score for hepatic fibrosis staging
Risk factors: - Pancreatic insufficiency with malabsorption - Chronic liver disease with portal hypertension - Age >65 with declining mucosal defenses - Family history of GI malignancy (first-degree relative) - Chronic constipation with diverticular disease risk - Diabetes with gastroparesis and motility dysfunction - Chronic PPI use >8 weeks without reassessment