From the Guidelines
Untreated eosinophilic esophagitis (EoE) can lead to serious complications, including food impaction, esophageal strictures, and progressive fibrosis, significantly impacting quality of life and nutritional status. The consequences of untreated EoE are severe and can result in long-term damage to the esophagus. According to the most recent and highest quality study, the chronic nature of EoE, where esophageal eosinophilia can lead to progressive fibrosis, necessitates long-term management and periodic endoscopic assessment to monitor disease activity 1.
Key Consequences of Untreated EoE
- Food impaction
- Esophageal strictures
- Progressive fibrosis
- Permanent esophageal damage
- Significant impact on quality of life and nutritional status
The natural history of untreated EoE is characterized by a progression from an inflammatory to a fibrostenotic phenotype, with cohort studies demonstrating that esophageal eosinophilia does not resolve over time and that patients with EoE do not "grow out of it" 1. Furthermore, the longer the duration of disease before diagnosis, the higher the proportion of patients who have a stricture or fibrostenotic phenotype at the time of diagnosis.
Importance of Long-term Management
- EoE is a chronic condition requiring maintenance therapy
- Periodic endoscopic assessment is necessary to monitor disease activity
- Treatment should be aimed at relieving symptoms and resolving esophageal eosinophilia
- The decision to advance treatment should be based on the degree of symptoms, the age of the patient, the presence of esophageal morphologic abnormalities, and the family's values and preferences 1.
In summary, untreated EoE can lead to severe complications, and long-term management is crucial to prevent progressive fibrosis and permanent esophageal damage. Treatment should be individualized, taking into account the patient's symptoms, age, and presence of esophageal morphologic abnormalities, as well as their values and preferences 1.
From the Research
Consequences of Untreated Eosinophilic Esophagitis
- Untreated eosinophilic esophagitis (EoE) can lead to esophageal remodeling with reduced compliance and stricture formation, which represents the main risk factor for food bolus impations 2
- Without treatment, inflammation can progress to fibrosis with the formation of strictures, leading to complications such as food impaction 3
- EoE can lead to esophageal remodeling and stricture formation that impairs quality of life 4
- Untreated EoE will lead to esophageal remodeling 5
Risk Factors and Complications
- The main risk factor for food bolus impactions is stricture formation due to untreated EoE 2
- Complications of untreated EoE include food impaction and esophageal stricture formation 3
- Esophageal stricture formation can impair quality of life 4