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Eosinophilic Oesophagitis — RACP Adult Medicine MCQ

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ModerateGastroenterologyEosinophilic OesophagitisRACP Adult Medicine

A 30-year-old man with a history of asthma and atopy presents with intermittent dysphagia to solids and food impaction. Upper endoscopy shows linear furrows, white exudates, and concentric rings (trachealization) in the oesophagus. Biopsies show >15 eosinophils per high-power field. What is the most likely diagnosis?

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Correct answer: C — Eosinophilic oesophagitis

Intermittent solid dysphagia and food impaction in a young atopic male with endoscopic findings of rings, furrows, and exudates, plus >15 eos/HPF on biopsy, is diagnostic of eosinophilic oesophagitis. First-line treatment is swallowed topical corticosteroids (fluticasone or budesonide). PPI therapy is no longer considered a diagnostic criterion.

Reference: GESA – 2024 – EoE Guidelines; Updated International EoE Guidelines 2022