Japanese

Eosinophilic Esophagitis and GERD Yasuhiko Abe 1 , Eiki Nomura 1 , Takeshi Sato 1 , Yu Sasaki 1 , Kazuya Yoshizawa 1 , Daisuke Iwano 1 , Makoto Yagi 1 , Kazuhiro Sakuta 1 , Rika Shibuya 1 , Shoichi Nishise 1 , Yoshifumi Inomata 2 , Katsuaki Kato 3 , Katsunori Iijima 4 , Yoshiyuki Ueno 1 1Department of Gastroenterology, Faculty of Medicine, Yamagata University, Yamagata, Japan 2Department of Gastroenterology, JR Sendai hospital, Sendai, Japan 3Cancer Detection Center of Miyagi Cancer Society, Sendai, Japan 4Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan Keyword: 好酸球性食道炎 , GERD , PPI-responsive esophageal eosinophilia , 縦走溝 , 輪状溝 pp.1911-1920
Published Date 2013/12/25
DOI https://doi.org/10.11477/mf.1403114023
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 GERD(gastroesophageal reflux disease), as well other secondary causes of esophageal eosinophilia, need to be excluded for the definitive diagnosis of EoE(eosinophilic esophagitis). However, there is a pathophysiological overlap between GERD and EoE. In adults, the two entities cannot be discriminated by symptoms alone. In addition to esophageal symptoms, dense eosinophilic inflammation(≧15eos/HPF), unresponsiveness to potent acid-inhibitory therapy and absence of abnormal acid reflux have been included in the diagnostic criteria for EoE and used for the discrimination of EoE from GERD. EoE appears to be easily distinguishable from GERD if typical endoscopic abnormalities such as linear furrows, rings and white exudates are present, but if not present, esophageal biopsies need to be obtained for histological assessment of esophageal eosinophilia. Recent diagnostic guidelines recommend a PPI trial discriminating EoE from PPI-responsive esophageal eosinophilia.


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