Eosinophilic Esophagitis Prognosis Overview

Eosinophilic esophagitis (EE or EoE) is still considered a relatively new disease, with the first cases described in the 1980’s. Since then the incidence of the disease has sharply increased, but there is still limited data on long term prognosis for EE. Tertiary medical centers specializing in the evalution of eosinophilic esophagitis have been collecting data regarding the long-term course.

One Study described the prognosis of EE at a teritiary medical center. Of the 620 patients who had been identified with eosinophilic esophagitis, there was information on 330 patients who had follow-up ranging between 1 to 14 years. The prognosis of eosinophilic esophagitis in this review had shown that 11 patients (3.3%) had complete resolution of disease, that is they no longer needed any form of diet or drug therapy. There were an additional 33 patients (10%) who had persistent disease, but were able to outgrow 1 or more of their food allergies.

A common question by families is what is the chance of that EE may progress to a malignancy if untreated. The basis for this concern is due to the fact that GERD can lead to Barrett’s esophagus. Barrett’s esophagus is a condition resulting in changes in the lining of the esophagus due to ongoing inflammation from acid refluxing up into the esophagus which can then progess to esophageal cancer. In EE, the assocation with Barrett’s is less certain. There have been only a few case reports of persons with EE also developing Barrett’s esophagus; this may be due to a coincidental overlap of two diseases rather than associated conditions. Our understanding about the prognosis of this eosinophilic esophagitis is still in its early stages, but there is no relation between esophageal cancer and EE described in any large review of EE patients.

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