Abstract
The global incidence and prevalence of eosinophilic gastrointestinal diseases is rising.
Clinically, acute eosinophilic esophagitis cannot be distinguished from other causes
of esophagitis. Endoscopic findings like rings, webs or furrows have a lower sensitivity
than previously assumed. An improvement of symptoms by proton-pump inhibitors also
doesn’t rule out the diagnosis – it has to be confirmed histologically. Early therapy
will prevent later complications like strictures and motility disorders. The presentation
of eosinophilic gastroenteritris/colitis is even less specific. Common cause seems
to be a Th2-mediated food allergy. Successful therapies include allergen-free diets
and topic steroids. Additionally, in the case of proton-pump inhibitor-responsive
eosinophilic esophagitis, proton pump inhibitors do not only block gastral acid production,
but may also have a direct inhibitory effect on Th2-immunity. Therefore, Th2-specific
biologicals have theoretical advantages, but they could not really convince in first
clinical studies.
Inzidenz und Prävalenz eosinophiler Erkrankungen des Magen-Darm-Trakts steigen weltweit
an. Klinisch ist die aktive eosinophile Ösophagitis aber kaum von einer akuten Ösophagitis
anderer Genese zu unterscheiden. Auch Endoskopie und das Ansprechen auf Protonenpumpenhemmer
sind hier keine sicheren Parameter. Das Bild der eosinophilen Gastroenteritis bzw.
Kolitis ist noch unspezifischer. Kompaktes Wissen zu diesem Thema bietet dieser Beitrag.
Schlüsselwörter
eosinophile Ösophagitis - eosinophile Gastroenteritis - eosinophile Kolitis - primär
eosinophile Erkrankungen des Gastrointestinaltrakts
Key words
eosinophilic esophagitis - eosinophilic gastroenteritis - eosinophilic colitis - eosinophilic
gastrointestinal disorders