Eosinophilic Esophagitis: The Role of Environmental Exposures

Eosinophilic esophagitis (EoE) is a chronic, non-IgE immune-mediated reaction characterized by eosinophilic infiltration leading to esophageal dysfunction, inflammation, and potential for fibrotic remodeling. Although food allergens are generally considered the leading trigger for EoE, emerging evidence suggests that modifiable environmental factors may also play a role in the pathogenesis of EoE. This article discusses the latest data regarding the role of the exposome, microbiome, and environmental allergens on the development and ongoing inflammation of EoE, focusing on the last 10 years of relevant studies.