What is the pathophysiology of eosinophilic esophagitis?

Updated: May 02, 2019
  • Author: Deepika Devuni, MBBS; Chief Editor: BS Anand, MD  more...
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The mechanism of eosinophilic esophagitis remains to be elucidated. However, a corrugated esophagus characterized by fine concentric mucosal rings is commonly observed in patients and is believed to be related to histamine released from sensitized mast cells in the esophageal wall. The release of histamine activates a cascade of reactions, culminating in acetylcholine release that contracts muscle fibers in the muscularis mucosae, resulting in the formation of concentric esophageal rings. [12, 13]

This hypothesis can be tested by performing endoscopic ultrasonography, which will reveal contraction of the muscle layers of the muscularis mucosae and may be related to immunoglobulin E (IgE) activation. [14]

More recent studies have suggested other potential etiopathophysiologic factors, such as an increased susceptibility to eosinophilic esophagitis when genetic predisposition is influenced by environmental factors, [4] or a co-occurrence of potential or probable celiac disease in adults with eosinophilic esophagitis. [15]

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