Eosinophilic esophagitis after total gastrectomy treated with proton pump inhibitors: a case report

Eosinophilic esophagitis (EoE) is a chronic, immune-mediated disorder in the esophagus characterized by symptoms related to esophageal dysfunction and eosinophil-predominant inflammation. EoE and Gastro Esophageal Reflux Disease (GERD) are known not to be mutually exclusive and share a complex relationship. Proton pump inhibitors (PPIs), which are generally used in the treatment of GERD, could be used to treat esophageal eosinophilia in suspected EoE. We report a rare case of EoE after total gastrectomy that responded to PPIs. Our case indicates that the onset of EoE does not necessarily require an acid reflux-induced antigen-mediated drive, and the action of PPIs in patients with active EoE is unrelated to gastric acid suppression.