[Eosinophilic esophagitis: new standards in diagnosis and therapy of chronic retrosternal pain].

Eosinophilic esophagitis is a chronic allergic inflammatory condition of the esophagus, which most often results in dysphagia, bolus impaction, heartburn or chest pain. Of particular importance is the differentiation from other inflammatory diseases of the esophagus, especially gastro-esophageal reflux disease. Response to treatment with proton pump inhibitors may help to distinguish between the different entities. The most important element in the diagnosis of eosinophilic esophagitis is to know its macro- and micromorphological characteristics. Biopsies from the proximal to the distal esophagus demonstrating > 15-20 eosinophilic granulocytes per high powered field favor the diagnosis. A multimodal therapeutic concept consists of the avoidance of specific allergens, topical or systemic glucocorticoids, oral antihistamines, leukotriene antagonists and, in cases of co-existing gastro-esophageal reflux disease, oral intake of proton pump inhibitors.