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Abstract
<p class="first" id="P2">Eosinophilic esophagitis (EoE) has emerged over the past
2 decades as a major cause
of upper gastrointestinal morbidity. Over this time, the epidemiology of EoE has also
rapidly evolved. EoE has transformed from a rare case-reportable condition to disease
that is commonly encountered in the gastroenterology clinic, hospital emergency room,
and endoscopy suite. The incidence and prevalence are increasing at rates that outpace
increased disease recognition. Current incidence estimates range from 5 to 10 cases
per 100,000, and current prevalence estimates range from 0.5 to 1 case per 1000. We
review the data and potential reasons behind this increase, examine risk factors,
and identify important areas for research into disease etiology. The article also
discusses the progression of EoE from an inflammatory to fibrostenotic phenotype.
An accurate view of the natural history of EoE is central to discussions with patients
regarding disease prognosis and decisions about long-term use of medical, endoscopic,
and diet therapies. Progressive remodelling appears to be gradual, but not universal,
and the duration of untreated disease is the best predictor of stricture risk. Ultimately,
prospective, long-term outcome studies focusing on multiple aspects of disease activity
are needed to fully understand the natural history of EoE.
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