Epidemiology of Eosinophilic Esophagitis

Abstract

Great strides have been made in understanding the epidemiology of EoE over the past two decades. Initial research focused on case description and characterization of the burden of disease. Research is now shifting to risk factor ascertainment, resulting in new and intriguing etiologic hypotheses. This paper will review the current knowledge related to the epidemiology of EoE. Demographic features and natural history will be described, data summarizing the prevalence and incidence of EoE throughout the world will be highlighted, and risk factors for EoE will be discussed. EoE can occur at any age, there is a male predominance, it is more common in Whites, and there is a strong association with atopic diseases. EoE is chronic, relapses are frequent, and persistent inflammation increases the risk of fibrostenotic complications. The prevalence is currently estimated at 0.5–1 in 1000, and EoE is now the most common cause of food impaction. EoE can be seen in 2–7% of patients undergoing endoscopy for any reason, and 12–23% undergoing endoscopy for dysphagia. The incidence of EoE is approximately 1/10,000 new cases per year, and the rise in incidence is outpacing increases in recognition and endoscopy volume. The reasons for this evolving epidemiology are not yet fully delineated, but possibilities include changes in food allergens, increasing aeroallergens and other environmental factors, the decrease of H. pyloriand early life exposures

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