Endoscopic Dilation for Fibrostenotic Complications in Eosinophilic Esophagitis—A Narrative Review
Esophageal fibrotic remodeling is a major complication of chronic inflammation in eosinophilic esophagitis (EoE) and represents one of the main determinants of symptoms in adult patients with EoE, with a remarkable impact on patients’ quality of life and the healthcare system. Esophageal fibrotic re...
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2025-05-01
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| author | Marco Michelon Edoardo Vincenzo Savarino Michele Montori Maria Eva Argenziano Pieter Jan Poortmans Pierfrancesco Visaggi Roberto Penagini David J. Tate Marina Coletta Andrea Sorge |
| author_facet | Marco Michelon Edoardo Vincenzo Savarino Michele Montori Maria Eva Argenziano Pieter Jan Poortmans Pierfrancesco Visaggi Roberto Penagini David J. Tate Marina Coletta Andrea Sorge |
| author_sort | Marco Michelon |
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| description | Esophageal fibrotic remodeling is a major complication of chronic inflammation in eosinophilic esophagitis (EoE) and represents one of the main determinants of symptoms in adult patients with EoE, with a remarkable impact on patients’ quality of life and the healthcare system. Esophageal fibrotic remodeling is diagnosed through upper gastrointestinal endoscopy, radiological studies, and a functional luminal imaging probe. However, diagnostic underestimation of esophageal strictures and suboptimal adherence to EoE guidelines still represent limitations of current clinical practice. Combined with medical therapy and/or elimination diets, endoscopic dilation remains the cornerstone treatment for esophageal strictures and rings, offering a safe and effective option for managing obstructive symptoms. Different modalities are available for esophageal endoscopic dilation of EoE, including mechanical and balloon dilators. Mechanical dilators provide tactile feedback during the procedure and exert longitudinal and radial forces. In contrast, balloon dilators apply a purely radial force and enable direct visualization of the esophageal mucosa during the procedure. Both mechanical and balloon dilators are safe and effective, with no single modality demonstrating clear superiority. Consequently, the choice of dilation technique is guided by stricture characteristics, the expertise of the endoscopist, and considerations related to the financial and environmental sustainability of the devices. This review aims to summarize the most relevant evidence on the endoscopic evaluation and dilation of fibrostenotic complications in EoE, also providing practical guidance for clinicians to optimize the endoscopic management of these patients. |
| format | Article |
| id | doaj-art-d05e18920b7d46be821fadbf43c841c4 |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-05-01 |
| publisher | MDPI AG |
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| series | Allergies |
| spelling | doaj-art-d05e18920b7d46be821fadbf43c841c42025-08-20T03:24:29ZengMDPI AGAllergies2313-57862025-05-01521710.3390/allergies5020017Endoscopic Dilation for Fibrostenotic Complications in Eosinophilic Esophagitis—A Narrative ReviewMarco Michelon0Edoardo Vincenzo Savarino1Michele Montori2Maria Eva Argenziano3Pieter Jan Poortmans4Pierfrancesco Visaggi5Roberto Penagini6David J. Tate7Marina Coletta8Andrea Sorge9Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, ItalyDepartment of Surgery, Oncology and Gastroenterology, University of Padua, 35122 Padua, ItalyDepartment of Gastroenterology and Hepatology, University Hospital of Ghent, 9000 Ghent, BelgiumDepartment of Gastroenterology and Hepatology, University Hospital of Ghent, 9000 Ghent, BelgiumDepartment of Gastroenterology and Hepatology, University Hospital of Ghent, 9000 Ghent, BelgiumGastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, ItalyDepartment of Pathophysiology and Transplantation, University of Milan, 20122 Milan, ItalyDepartment of Gastroenterology and Hepatology, University Hospital of Ghent, 9000 Ghent, BelgiumGastroenterology and Endoscopy Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyDepartment of Pathophysiology and Transplantation, University of Milan, 20122 Milan, ItalyEsophageal fibrotic remodeling is a major complication of chronic inflammation in eosinophilic esophagitis (EoE) and represents one of the main determinants of symptoms in adult patients with EoE, with a remarkable impact on patients’ quality of life and the healthcare system. Esophageal fibrotic remodeling is diagnosed through upper gastrointestinal endoscopy, radiological studies, and a functional luminal imaging probe. However, diagnostic underestimation of esophageal strictures and suboptimal adherence to EoE guidelines still represent limitations of current clinical practice. Combined with medical therapy and/or elimination diets, endoscopic dilation remains the cornerstone treatment for esophageal strictures and rings, offering a safe and effective option for managing obstructive symptoms. Different modalities are available for esophageal endoscopic dilation of EoE, including mechanical and balloon dilators. Mechanical dilators provide tactile feedback during the procedure and exert longitudinal and radial forces. In contrast, balloon dilators apply a purely radial force and enable direct visualization of the esophageal mucosa during the procedure. Both mechanical and balloon dilators are safe and effective, with no single modality demonstrating clear superiority. Consequently, the choice of dilation technique is guided by stricture characteristics, the expertise of the endoscopist, and considerations related to the financial and environmental sustainability of the devices. This review aims to summarize the most relevant evidence on the endoscopic evaluation and dilation of fibrostenotic complications in EoE, also providing practical guidance for clinicians to optimize the endoscopic management of these patients.https://www.mdpi.com/2313-5786/5/2/17dilation in eosinophilic esophagitisdilation in EoEendoscopic treatment of fibrosis in eosinophilic esophagitisesophageal fibrosis in EoEhow to perform dilation in EoE |
| spellingShingle | Marco Michelon Edoardo Vincenzo Savarino Michele Montori Maria Eva Argenziano Pieter Jan Poortmans Pierfrancesco Visaggi Roberto Penagini David J. Tate Marina Coletta Andrea Sorge Endoscopic Dilation for Fibrostenotic Complications in Eosinophilic Esophagitis—A Narrative Review Allergies dilation in eosinophilic esophagitis dilation in EoE endoscopic treatment of fibrosis in eosinophilic esophagitis esophageal fibrosis in EoE how to perform dilation in EoE |
| title | Endoscopic Dilation for Fibrostenotic Complications in Eosinophilic Esophagitis—A Narrative Review |
| title_full | Endoscopic Dilation for Fibrostenotic Complications in Eosinophilic Esophagitis—A Narrative Review |
| title_fullStr | Endoscopic Dilation for Fibrostenotic Complications in Eosinophilic Esophagitis—A Narrative Review |
| title_full_unstemmed | Endoscopic Dilation for Fibrostenotic Complications in Eosinophilic Esophagitis—A Narrative Review |
| title_short | Endoscopic Dilation for Fibrostenotic Complications in Eosinophilic Esophagitis—A Narrative Review |
| title_sort | endoscopic dilation for fibrostenotic complications in eosinophilic esophagitis a narrative review |
| topic | dilation in eosinophilic esophagitis dilation in EoE endoscopic treatment of fibrosis in eosinophilic esophagitis esophageal fibrosis in EoE how to perform dilation in EoE |
| url | https://www.mdpi.com/2313-5786/5/2/17 |
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