Esophageal dilation for eosinophilic esophagitis: it’s safe! Why aren’t we doing more dilations?

Eosinophilic esophagitis (EoE) was first recognized as an inflammatory disease of the esophagus with mucosal eosinophilia, but over the past 10 years it has been slowly realized that esophageal remodeling with stricture disease is an important feature, especially in adult patients. Esophageal strictures are present in 30% to 80% of adults with EoE.1 Several studies confirm that the presence and severity of stricture disease coincides with the longer duration of undiagnosed disease.1,2 In this latter stage, proton pump inhibitors (PPIs), topical steroids, dietary therapy, or a combination of these measures may improve any ongoing inflammation, but symptoms often persist until the fibrostenosis is disrupted by esophageal dilation.

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