EoE incidence and prevalence are increasing at a rate that is outpacing increased recognition or detection.[11]Dellon ES. Epidemiology of eosinophilic esophagitis. Gastroenterol Clin North Am. 2014 Jun;43(2):201-18.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4019938
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[12]Dellon ES, Erichsen R, Baron JA, et al. The increasing incidence and prevalence of eosinophilic oesophagitis outpaces changes in endoscopic and biopsy practice: national population-based estimates from Denmark. Aliment Pharmacol Ther. 2015 Apr;41(7):662-70.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4504237
http://www.ncbi.nlm.nih.gov/pubmed/25684441?tool=bestpractice.com
EoE is the most common cause of food impactions in patients presenting to the emergency department, and is present in more than half of these cases.[13]Sperry SL, Crockett SD, Miller CB, et al. Esophageal foreign-body impactions: epidemiology, time trends, and the impact of the increasing prevalence of eosinophilic esophagitis. Gastrointest Endosc. 2011 Nov;74(5):985-91.
https://www.giejournal.org/article/S0016-5107(11)01911-0/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/21889135?tool=bestpractice.com
[14]Kerlin P, Jones D, Remedios M, et al. Prevalence of eosinophilic esophagitis in adults with food bolus obstruction of the esophagus. J Clin Gastroenterol. 2007 Apr;41(4):356-61.
http://www.ncbi.nlm.nih.gov/pubmed/17413601?tool=bestpractice.com
[15]Desai TK, Stecevic V, Chang CH, et al. Association of eosinophilic inflammation with esophageal food impaction in adults. Gastrointest Endosc. 2005 Jun;61(7):795-801.
http://www.ncbi.nlm.nih.gov/pubmed/15933677?tool=bestpractice.com
The mean estimate of prevalence throughout Europe and North America since 2017 is 63 per 100,000 people (rising from 15 per 100,000 people pre 2007), with a pooled incidence rate of 6.2 per 100,000 people per year (rising from 2.6 per 100,000 before 2007).[16]Navarro P, Arias Á, Arias-González L, et al. Systematic review with meta-analysis: the growing incidence and prevalence of eosinophilic oesophagitis in children and adults in population-based studies. Aliment Pharmacol Ther. 2019 May;49(9):1116-25.
http://www.ncbi.nlm.nih.gov/pubmed/30887555?tool=bestpractice.com
The condition has been reported throughout the world, and the prevalence in South America, and Australia is similar to that in the US.[11]Dellon ES. Epidemiology of eosinophilic esophagitis. Gastroenterol Clin North Am. 2014 Jun;43(2):201-18.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4019938
http://www.ncbi.nlm.nih.gov/pubmed/24813510?tool=bestpractice.com
[17]Straumann A, Simon HU. Eosinophilic esophagitis: escalating epidemiology? J Allergy Clin Immunol. 2005 Feb;115(2):418-9.
http://www.jacionline.org/article/S0091-6749(04)03044-1/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/15696105?tool=bestpractice.com
[18]Hruz P, Straumann A, Bussmann C, et al. Escalating incidence of eosinophilic esophagitis: a 20-year prospective, population-based study in Olten County, Switzerland. J Allergy Clin Immunol. 2011 Dec;128(6):1349-50.
http://www.jacionline.org/article/S0091-6749(11)01484-9/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/22019091?tool=bestpractice.com
[19]Cherian S, Smith NM, Forbes DA. Rapidly increasing prevalence of eosinophilic oesophagitis in Western Australia. Arch Dis Child. 2006 Dec;91(12):1000-4.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2083004
http://www.ncbi.nlm.nih.gov/pubmed/16877474?tool=bestpractice.com
[20]Arias Á, Lucendo AJ. Prevalence of eosinophilic oesophagitis in adult patients in a central region of Spain. Eur J Gastroenterol Hepatol. 2013 Feb;25(2):208-12.
http://www.ncbi.nlm.nih.gov/pubmed/23075697?tool=bestpractice.com
The prevalence is far lower in Asian countries, where the condition remains rare, but the reason for this difference is unknown.[21]Shi YN, Sun SJ, Xiong LS, et al. Prevalence, clinical manifestations and endoscopic features of eosinophilic esophagitis: a pathological review in China. J Dig Dis. 2012 Jun;13(6):304-9.
http://onlinelibrary.wiley.com/doi/10.1111/j.1751-2980.2012.00593.x/full
http://www.ncbi.nlm.nih.gov/pubmed/22624553?tool=bestpractice.com
[22]Kinoshita Y, Furuta K, Ishimaura N, et al. Clinical characteristics of Japanese patients with eosinophilic esophagitis and eosinophilic gastroenteritis. J Gastroenterol. 2013 Mar;48(3):333-9.
http://www.ncbi.nlm.nih.gov/pubmed/22847555?tool=bestpractice.com
EoE will be seen in 6% to 7% of patients undergoing upper endoscopy for any indication.[23]Veerappan GR, Perry JL, Duncan TJ, et al. Prevalence of eosinophilic esophagitis in an adult population undergoing upper endoscopy: a prospective study. Clin Gastroenterol Hepatol. 2009 Apr;7(4):420-6.
http://www.cghjournal.org/article/S1542-3565(08)01040-9/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/19162236?tool=bestpractice.com
In patients undergoing upper endoscopy for symptoms of dysphagia, EoE will be seen in 15% to 23% of patients.[24]Prasad GA, Alexander JA, Arora AS, et al. Eosinophilic esophagitis: prevalence and predictive factors (Ab 56). Am J Gastroenterol. 2006;101(suppl):S60-1.[25]Dellon ES, Speck O, Woodward K, et al. Clinical and endoscopic characteristics do not reliably differentiate PPI-responsive esophageal eosinophilia and eosinophilic esophagitis in patients undergoing upper endoscopy: a prospective cohort study. Am J Gastroenterol. 2013 Dec;108(12):1854-60.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574875
http://www.ncbi.nlm.nih.gov/pubmed/24145677?tool=bestpractice.com
EoE has been reported in patients of all ages, but is more commonly seen in children and young adults, with the peak prevalence occurring between ages 30 years and 40 years.[26]Dellon ES, Jensen ET, Martin CF, et al. Prevalence of eosinophilic esophagitis in the United States. Clin Gastroenterol Hepatol. 2014 Apr;12(4):589-96.
https://www.cghjournal.org/article/S1542-3565(13)01304-9/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/24035773?tool=bestpractice.com
However, because it is chronic and not fatal, the frequency of the disease will increase in adults. Approximately two-thirds of patients are male, although the reasons for this are unknown.[27]Lynch KL, Dhalla S, Chedid V, et al. Gender is a determinative factor in the initial clinical presentation of eosinophilic esophagitis. Dis Esophagus. 2016 Feb-Mar;29(2):174-8.
http://www.ncbi.nlm.nih.gov/pubmed/25626069?tool=bestpractice.com
[28]Dellon ES, Liacouras CA. Advances in clinical management of eosinophilic esophagitis. Gastroenterology. 2014 Dec;147(6):1238-54.
https://www.gastrojournal.org/article/S0016-5085(14)00980-9/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/25109885?tool=bestpractice.com
It is more common in white people compared with nonwhite people, although it has been reported in multiple ethnic and racial populations.[29]Sperry SL, Woosley JT, Shaheen NJ, et al. Influence of race and gender on the presentation of eosinophilic esophagitis. Am J Gastroenterol. 2012 Feb;107(2):215-21.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4584147
http://www.ncbi.nlm.nih.gov/pubmed/21971538?tool=bestpractice.com
[30]Moawad FJ, Dellon ES, Achem SR, et al. Effects of race and sex on features of eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2016 Jan;14(1):23-30.
http://www.ncbi.nlm.nih.gov/pubmed/26343181?tool=bestpractice.com