Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease of the esophagus. It is diagnosed in the setting of symptoms of esophageal dysfunction and an eosinophilic predominant infiltrate in the esophagus. The condition is rapidly increasing in incidence and prevalence and is commonly encountered in gastroenterology and allergy practices, emergency departments, and primary care settings. Over the past decade, there have been paradigm shifts in disease diagnosis and management, increases in knowledge about EoE risk factors, natural history, and pathogenesis, and development of validated outcome metrics. This updated American College of Gastroenterology Clinical Guideline uses Grading of Recommendations, Assessment, Development, and Evaluation methodology to make recommendations across domains of diagnosis, treatment, monitoring and assessment of response, and pediatric-specific considerations. Proton pump inhibitors, topical steroids, empiric diet elimination, a biologic, and esophageal dilation are all recommended treatments; feeding therapy is used adjunctively in children with food aversion or feeding dysfunction. Monitoring with clinical, endoscopic, and histologic assessments is recommended to assess for treatment response and follow patients over time with maintenance therapy. When evaluating and following patients with EoE, consideration should be given to assessing and controlling both the inflammatory and fibrostenotic aspects of disease.

嗜酸性食管炎（EoE）是一种慢性免疫介导的食道疾病。它是在食管功能障碍的症状和嗜酸性粒细胞主要浸润在食管的设置诊断。此病的发病率和流行率正在迅速增加，常见于胃肠病学和过敏实践、急诊科和初级保健机构。在过去的十年中，疾病诊断和管理模式发生了转变，对EoE风险因素、自然史和发病机制的了解有所增加，并制定了经过验证的结果指标。这一更新的美国胃肠病学会临床指南使用分级推荐、评估、发展和评估方法，在诊断、治疗、监测和评估反应以及儿科特定考虑等领域提出建议。质子泵抑制剂、局部类固醇、经验性饮食消除、生物制剂和食管扩张都是推荐的治疗方法；进食疗法辅助用于有食物厌恶或进食功能障碍的儿童。建议通过临床、内窥镜和组织学评估进行监测，以评估治疗反应，并对患者进行长期的维持治疗。在评估和跟踪EoE患者时，应考虑评估和控制疾病的炎症和纤维狭窄方面。