Clinical Endoscopy

Role of endoscopy in eosinophilic esophagitis: Eun-Jin Yang, Kee Wook Jung; Clin Endosc 2025;58(1):1-9. Published online July 5, 2024; DOI: https://doi.org/10.5946/ce.2024.023

Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease involving inflammation of the esophagus. Endoscopy is essential in the diagnosis and treatment of EoE and shows typical findings, including esophageal edema, rings, exudates, furrows, and stenosis. However, studies involving pediatric and adult patients with EoE suggest that even a normally appearing esophagus can be diagnosed as EoE by endoscopic biopsy. Therefore, in patients with suspected EoE, biopsy samples should be obtained from the esophagus regardless of endoscopic appearance. Moreover, follow-up endoscopies with biopsy after therapy initiation are usually recommended to assess response. Although previous reports of endoscopic ultrasonography findings in patients with EoE have shown diffuse thickening of the esophageal wall, including lamina propria, submucosa, and muscularis propria, its role in EoE remains uncertain and requires further investigation. Endoscopic dilation or bougienage is a safe and effective procedure that can be used in combination with medical and/or dietary elimination therapy in patients with esophageal stricture for the management of dysphagia and to prevent its recurrence.

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Frontline Gastroenterology.2026; : flgastro-2025-103455. CrossRef
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Kwangbeom Park, Chang Hoon Oh, Do Hoon Kim, Ji Hoon Shin, Hee Kyong Na, Ji Yong Ahn, Jeong Hoon Lee, Kee Wook Jung, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung
The Korean Journal of Internal Medicine.2026; 41(3): 462. CrossRef
Esophageal Remodeling in Eosinophilic Esophagitis: Clinical and Functional Implications
Kee Wook Jung
Gut and Liver.2026; 20(3): 341. CrossRef
Eosinophilic esophageal myositis: a comparative study of distinguishing features, diagnostic challenges, and therapeutic insights
Rui Wu, Yunyun Zhang, Wei Zhao, Huaqing Zhu, Hongjiao Wu, Xinyi Lu, Wei Zhang, Xiaoping Zou, Nina Zhang
Therapeutic Advances in Gastroenterology.2026;[Epub] CrossRef
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M Romero Martínez, A Gómez Gómez, M Muñoz Tornero, M Alajarín Cervera, T Fernández Llamas, C Bógalo Romero, L Madrigal Bayonas, F J Sánchez Roncero, G Calatayud Vidal, F Alberca De Las Parras
Endoscopy.2026; 58(S 03): S661. CrossRef
The Dynamic Evolution of Eosinophilic Esophagitis
Amir Farah, Tarek Assaf, Jawad Hindy, Wisam Abboud, Mostafa Mahamid, Edoardo Vincenzo Savarino, Amir Mari
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The Therapeutic Pipeline for Eosinophilic Esophagitis: Current Landscape and Future Directions
Andrea Pasta, Luisa Bertin, Amir Mari, Francesco Calabrese, Amir Farah, Giulia Navazzotti, Matteo Ghisa, Vincenzo Savarino, Edoardo Vincenzo Savarino, Edoardo Giovanni Giannini, Elisa Marabotto
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A Case of Eosinophilic Esophagitis Associated with Herpes Esophagitis in a Pediatric Patient: Jisun Kim, Kunsong Lee, Wonae Lee; Clin Endosc 2019;52(6):606-611. Published online July 17, 2019; DOI: https://doi.org/10.5946/ce.2019.021

Abstract PDF PubReader ePub

Eosinophilic esophagitis is a rare disease in Asian countries, but its incidence is growing rapidly in Western countries. The main pathophysiology of eosinophilic esophagitis is esophageal epithelial barrier dysfunction; disruption of the esophageal epithelial barrier easily induces antigen sensitization to foods and aeroallergens, which leads to subsequent esophageal inflammation as a result of eosinophil recruitment. Here we report a case of an 11-year-old Korean boy who suffered from fever, odynophagia, dysphagia, and chest pain. His upper endoscopic findings showed longitudinal ulcers with a volcano-like appearance at the distal esophagus. Polymerase chain reaction test results and biopsy specimens were positive for herpes simplex virus type 1. He was treated with acyclovir and a proton pump inhibitor, but his follow-up endoscopy showed typical patterns of eosinophilic esophagitis, and the biopsy specimens were compatible with the diagnostic criteria for eosinophilic esophagitis. Therefore, we report a very rare case of eosinophilic esophagitis after herpes esophagitis in a Korean child with normal immunity.

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A unique association between herpes simplex esophagitis and eosinophilic esophagitis: a case report
Sahil Sabharwal, Brandyn Young, Deepak Sabharwal, Sarat C. Sabharwal, Terryl Ortego
Exploration of Digestive Diseases.2026;[Epub] CrossRef
Dysphagia and chest pain in a 7-year-old girl
Charles B Chen, Balaji Cherupalla
Laboratory Medicine.2025; 56(1): 97. CrossRef
РОЛЬ ГЕРПЕСВИРУСОВ В РАЗВИТИИ ХРОНИЧЕСКОГО ВОСПАЛЕНИЯ СЛИЗИСТОЙ ОБОЛОЧКИ ВЕРХНИХ ОТДЕЛОВ ОРГАНОВ ПИЩЕВАРЕНИЯ У ДЕТЕЙ
Анастасия Павловна Листопадова, Мария Олеговна Цепилова, Анастасия Алексеевна Горовая
Children's medicine of the North-West.2025; 13(1): 120. CrossRef
Feline herpesvirus-1-related multiple respiratory eosinophilic nodules in an adult cat receiving long-term oral prednisolone
Helen S Philp, Lynelle R Johnson, Eunju April Choi, Robert J Brosnan, Robert T Slater
Journal of Feline Medicine and Surgery Open Reports.2024;[Epub] CrossRef
Odynophagia in a young adult: revisiting herpetic esophagitis and eosinophilic esophagitis
Hiral Patel, Samantha Minh Thy Nguyen, Aaisha Haque, Guha Krishnaswamy
BMJ Case Reports.2022; 15(11): e251238. CrossRef
A Patient with Eosinophilic Esophagitis and Herpes Simplex Esophagitis: A Case Report and Literature Review
Hemnishil K. Marella, Jiten P. Kothadia, Nasir Saleem, Bilal Ali, Yousef Abdel-Aziz, Vamsee Mupparaju, Twisha Oza, Abdallah Azouz, Colin W. Howden, Ken Haruma
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UPPER GASTROINTESTINAL BLEEDING DUE TO CONCOMITANT ESOPHAGEAL VARICES AND HERPES SIMPLEX VIRUS ESOPHAGITIS IN A 70-YEAR-OLD PATIENT
Mahdieh Ghoddoosi, Kimia Jazi, Zahra Hajrezaei, Mohammad Amin Habibi, Sajjad Ahmadpour, Mahdi Pezeshki Modares
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Rare Etiology of Odynophagia in a Female Adolescent
Anastasios Koutsoumourakis, Asterios Gagalis, Maria Fotoulaki, Maria Stafylidou
Case Reports in Gastroenterology.2021; 15(1): 352. CrossRef
An Update on Eosinophilic Esophagitis: Etiological Factors, Coexisting Diseases, and Complications
Samiullah Khan, Xiaopei Guo, Tianyu Liu, Muhammad Iqbal, Kui Jiang, Lanping Zhu, Xin Chen, Bang-mao Wang
Digestion.2021; 102(3): 342. CrossRef

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Prevalence of Eosinophilic Esophagitis in Adult Patients with Upper Gastrointestinal Symptoms in a Locality in Upper Egypt: Magdy Fouad, Yasser Mahrous Fouad, Hamdy Ahmed Mokareb, Elham Ahmed Mohamed, Dalia Mohammed Abdel-Rehim; Clin Endosc 2018;51(4):357-361. Published online April 11, 2018; DOI: https://doi.org/10.5946/ce.2017.166

Abstract PDF PubReader ePub

Background
/Aims: Eosinophilic esophagitis (EoE) is gaining importance in the diagnosis of upper gastrointestinal (UGI) symptoms. Diagnosis is based on the clinical presentation of esophageal dysfunction and pathological findings in the absence of other causes of tissue eosinophilia. Our study was designed to evaluate EoE prevalence in patients with UGI symptoms in our locality (El-Minia, Egypt).
Methods
This single-center, cross-sectional study recruited all patients with UGI symptoms who agreed for endoscopic evaluation. Esophageal biopsy samples were obtained and histological evaluation for the presence of eosinophils was performed for every patient. EoE was defined when at least 15 eosinophils were present in a single high-power field, in the absence of other causes of esophageal eosinophilia.
Results
Between 2013 and 2015, 218 of 476 adult patients with UGI symptoms underwent upper endoscopy after giving consent. Among the 218 patients, only 4 (1.87%) had the diagnosis of EoE based on the presence of eosinophils in esophageal biopsies and exclusion of other causes of esophageal eosinophilia. Three patients with EoE presented mainly with dysphagia (75%) and/or other UGI symptoms, such as heartburn.
Conclusions
We observed a low prevalence of EoE in our locality. The diagnosis of EoE should be considered in patients with dysphagia and/or heartburn.

Citations

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Eosinophilic Esophagitis in the Middle East: Insight From a Comprehensive Systematic Review
Nouran Alwisi, Sidra Abdul Moqeeth, Muneera Al‐Mohannadi
JGH Open.2026;[Epub] CrossRef
Prevalence of eosinophilic esophagitis in refractory gastroesophageal reflux disease in Egyptian patients
Abdelnaser Gadallah, El Sayed El Shayeb, Basma Hisham, Asmaa Gaber Abdou, Ezzat Abdalla
The Egyptian Journal of Internal Medicine.2025;[Epub] CrossRef
Indications and endoscopic findings of upper gastrointestinal diseases in Africa: A systematic review & meta-analysis
Seid Mohammed Abdu, Ebrahim Msaye Assefa, Hussen Abdu, Muhammad Salman Bashir
PLOS ONE.2025; 20(3): e0319854. CrossRef
Prevalence and patterns of peptic ulcer disease in Africa: a systematic review and meta-analysis
Seid Mohammed Abdu, Ebrahim Msaye Assefa, Hussen Abdu
BMC Gastroenterology.2025;[Epub] CrossRef
Eosinophilic Esophagitis and Inflammatory Bowel Disease: What Are the Differences?
Hassan Melhem, Jan Hendrik Niess
International Journal of Molecular Sciences.2024; 25(15): 8534. CrossRef
Prevalence of esophageal eosinophilia in patients referred for diagnostic upper gastrointestinal endoscopy
Nancy Abdel Fattah Ahmed, Hebat-Allah Moheb Amer, Dina Abdallah Ibrahim, Islam Abd El-Hamid El-Zayyadi
Egyptian Liver Journal.2021;[Epub] CrossRef
Changing Concept of the Prevalence of Eosinophilic Esophagitis: Visible and Hidden Patients
Hyuk Lee
Clinical Endoscopy.2018; 51(4): 307. CrossRef

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Analysis of the Clinicopathologic Features of Eosinophilic Esophagitis: Comparative Study with Nonobstructive Dysphagia: Kwang Hyun Kim, M.D., Il Hyung Chung, M.D., Jie-Hyun Kim, M.D., Young Hoon Youn, M.D., Sun Och Yoon, M.D.*, Hyojin Park, M.D. and Sang In Lee, M.D.; Korean J Gastrointest Endosc 2011;42(3):143-151. Published online March 28, 2011

Abstract PDF

Background/Aims: Eosinophilic esophagitis (EoE) has emerged as one of the most common causes of dysphagia and esophageal food impactions. However, it is doubtful that gastroenterologists and pathologists make the correct diagnosis of EoE because of the insufficient recognition of EoE based on the endoscopic and pathological findings. This study was performed to investigate the symptoms and the endoscopic and pathologic findings of EoE as compared with those of nonobstructive dysphagia (NOD).

Methods: We retrospectively reviewed the medical records and the endoscopic and pathologic findings from 12 patients who were diagnosed with EoE based on an eosinophil count of ≥20 per high-power field (HPF) and 13 patients diagnosed with NOD, and these patients were treated at our hospital from June 2006 till October 2010.

Results: The endoscopic findings of EoE included rings (41.7%), furrows (75.0%), exudates (33.3%), mucosal friability (8.3%) and multi-findings (6.7%). Furrows and multi-findings were identified more frequently in EoE as comparison to that in NOD. The pathologic findings revealed that the maximal eosinophil counts/HPF were 87.2 (range 20∼232) and 2.2 (0∼11) in EoE and NOD, respectively. Moreover, eosinophil microabscess (58.3%), degranulation (100%) and spongiosis (91.7%) were more significantly observed in EoE compared with that in NOD.

Conclusions: EoE had specific endoscopic and clinicopathologic features that distinguish it from NOD. For patients with dysphagia, the endoscopic and pathologic findings of EoE should be kept in mind. (Korean J Gastrointest Endosc 2011;42:143-151)

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Two Cases of Eosinophilic Esophagitis Treated with a Proton Pump Inhibitor and a Systemic Steroid: Jeong Rok Lee, M.D., Kyung Ho Song, M.D., Won Joong Jeon, M.D., Sang Jin Lee, M.D., Byung Hyo Cha, M.D., Jin Dong Kim, M.D., Young Nam Kim, M.D. and Chang Won Ha, M.D.*; Korean J Gastrointest Endosc 2010;41(2):85-89. Published online August 30, 2010

Abstract PDF: Eosinophilic esophagitis is a chronic inflammatory disorder characterized by dense eosinophilic infiltration of the esophageal mucosa. As an emerging disease during the last decade, eosinophilic esophagitis has gained increased recognition in both the medical and research communities. The pathogenesis is incompletely understood and food allergies and aeroallergens have been implicated. The most common clinical symptoms in adults are dysphagia and food impaction. We diagnosed two cases as eosinophilic esophagitis and treated them with a proton pump inhibitor and a systemic steroid. We confirmed improvements in clinical presentation and histologic findings and report these cases. (Korean J Gastrointest Endosc 2010;41:85-89)

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Eosinophilic Esophagitis: Yun Ju Jo, M.D.; Korean J Gastrointest Endosc 2009;39(6):329-337. Published online December 30, 2009

Abstract PDF: Eosinophilic esophagitis, as a new emerging disease during the last decade, is a clinicopathologic disorder of the esophagus, and it is characterized by dense esophageal eosinophilic infiltrations and typical esophageal symptoms. These patients usually present with dysphagia, food impaction or refractory reflux symptoms, and biopsy of the esophagus shows more than 15 eosinophils per high-power field. The typical findings on endoscopy are linear furrows, ringed esophagus, mucosal nodularities, whitish plaques and/or stricture. It is essential to exclude the known causes of tissue eosinophilia such as gastroesophageal reflux disease, eosinophilic gastroenteritis, infections, drug, hypersensitivity, Crohn's disease or malignancy. The majority of these patients have an atopy or allergic disorders, so other causes of eosinphilia should be evaluated. The therapeutic options include acid suppression, steroids, dietary modification, endoscopic dilatation, etc. Eosinophilic esopahgitis has recently been reported in Korea. Future schematic studies about this new disease are needed. (Korean J Gastrointest Endosc 2009;39:329-337)

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Three Cases of Eosinophilic Esophagitis with Dysphagia as a Chief Complaint: Byungjun Lee, M.D., Hyojin Park, M.D., Hongsun Yoon, M.D., Hyun Ki Kim, M.D.* and Hee Sun Kim, M.D.^†; Korean J Gastrointest Endosc 2008;36(3):145-149. Published online March 30, 2008

Abstract PDF: The incidence of adult eosinophillic esophagitis has been on the increase greatly in recent years, but the disease has been rarely reported in Korea. Eosinophilic esophagitis is a chronic inflammatory disease causing dysphagia and food impaction. A round ring, longitudinal furrows and mucosal friability are the major findings seen by endoscopy. Eosionophilc esophagitis is confirmed by pathology when more than 20 eosinophils are found on microscopy with use of a high power field. We experienced three cases of eosinophilic esophagitis with complaints of dysphagia. (Korean J Gastrointest Endosc 2008;36:145-149)

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