Eosinophilic Esophagitis: No Longer a Rarity in Asia—A Growing Concern for Clinicians
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Eosinophilic esophagitis (EoE)—a chronic, immune-mediated disease—is characterized by eosinophilic infiltration of the esophageal epithelium, leading to symptoms, such as dysphagia and food impaction. While the prevalence of EoE is well documented in Western populations, data from Asian countries, including Korea, have historically been sparse [1]. Furthermore, changing in diagnostic criteria over the past decades have posed challenges to the longitudinal assessments of its epidemiology [2].
Recent studies have suggested an increasing diagnostic trend of EoE in Korea [3-5]. In a retrospective analysis conducted between 2006 and 2016, only a modest increase was observed in the number of esophageal biopsies; however, the number of EoE diagnoses rose significantly over the same period (p<0.001) [3]. Comparable trends have also been documented in other regions of Korea, including Busan and Gyeongnam [6].
Evidence from neighboring Asian countries further substantiates this increasing recognition. A recent nationwide Japanese study, using International Classification of Disease-coded data, demonstrated that the incidence and prevalence of EoE in 2022 were 2.82 (95% confidence interval [CI], 2.44–3.26) and 10.68 (95% CI, 10.01–11.37) per 100000 person-years, respectively, reflecting almost threefold and eightfold increases compared to 2017 [7].
Moreover, a recent meta-analysis of Asian studies revealed a significant upward trend in both prevalence and incidence over time.8 Between 2005–2009 and 2015–2019, population-based prevalence rose from 19.8 (95% CI, 19.5–20.1) to 73.0 (95% CI, 72.8–73.2) per 100000 person-years [8].
Taken together, these findings underscore that EoE is no longer a rare entity in Asia. With increasing diagnostic awareness and rising case numbers, the burden of EoE is becoming more apparent, especially for gastroenterologists in Korea.
In this issue, a comprehensive review article titled “Eosinophilic Esophagitis: Emerging Insights Into Diagnosis and Management [9]” offers an up-to-date synthesis of current knowledge. The review discusses state-of-the-art diagnostic tools, therapeutic approaches, including dietary strategies, pharmacologic agents, and endoscopic interventions, and highlights emerging biologic therapies. Importantly, it emphasizes the requirement for a unified diagnostic framework and optimal treatment algorithms to address this increasingly recognized and clinically significant disease.
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Availability of Data and Material
Data sharing not applicable to this article as no datasets were generated or analyzed during the study.
Conflicts of Interest
The author has no financial conflicts of interest.
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