Diagnosis and treatment of eosinophilic esophagitis in Japan

Patients in Japan affected by eosinophilic esophagitis (EoE), considered to be a dietary allergen related chronic esophageal disease, are slowly increasing. For diagnosis, careful assessments of atopic diathesis and symptoms, an endoscopic examination focusing on EoE characteristic findings, and histopathological examination of appropriate biopsy samples are important. When clinicopathological examination results suggest EoE, proton pump inhibitor (PPI) administration should be attempted to determine the response (PPI-responsive esophageal eosinophilia, PPI-REE). For PPI-refractory cases, oral topical glucocorticoid administration is the first therapeutic option, followed by systemic glucocorticoids as necessary. Evidence-based guidelines are currently under development in Japan for standardizing diagnosis and treatment.