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Difficulty swallowing (dysphagia) and impaction of food in the oesophagus can suggest eosinophilic oesophagitis (EO) but symptoms can also be vague such as nausea and anorexia with vomiting and poor growth. This diagnosis is made on biopsy showing eosinophils infiltrating the mucosa. It is a type two cytokine initiated inflammatory condition which is increasing in prevalence. The Archivist has used, dietary manipulation, proton pump inhibitors or topical steroids with variable success. As our understanding of the process increases monoclonal antibodies are quickly becoming part of the treatment regimen.Dellon ES et al (N Engl J Med 2022;387:2317–2330) have explored the value …
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