# Response to Proton‐Pump Inhibitors Therapy in Pediatric Patients With Eosinophilic Esophagitis in Bogotá, Colombia

## TL;DR

This study examines how children in Bogotá, Colombia respond to proton-pump inhibitor therapy for eosinophilic esophagitis, finding a 47% histological remission rate.

## Contribution

First study to assess PPI response in Colombian pediatric EoE patients.

## Key findings

- 47% of patients achieved histological remission with PPI therapy.
- Histological evaluation was the most reliable marker of treatment success.
- No significant differences in demographics or symptoms between responders and nonresponders.

## Abstract

Eosinophilic esophagitis (EoE) is a chronic immune‐mediated disease and a leading cause of food impaction in pediatric populations, with potential functional and structural complications. Proton‐pump inhibitors (PPIs) are widely used as first‐line therapy, but the response rate in Colombian children remains unknown. This study aimed to determine the initial histologic response to PPI therapy and describe clinical, endoscopic, and histological characteristics in a sample of pediatric patients with EoE from Bogotá, Colombia.

A retrospective observational longitudinal study of patients aged 2–18 years diagnosed with EoE at a tertiary care center between 2015 and 2022 was conducted. Patients underwent initial clinical and endoscopic assessment confirming esophageal eosinophilia (≥ 15 eosinophils per high‐power field [eos/hpf]), followed by at least 8‐week course of PPI therapy and a subsequent clinical‐endoscopic re‐evaluation. Treatment response was defined histologically as < 15 eos/hpf in follow‐up esophageal biopsy. Demographic, clinical, endoscopic, and histological data were analyzed using descriptive and bivariate statistics.

We included 34 patients (median age 11 years; 61.8% boys). Sixteen (47%) achieved histological remission with initial PPI therapy. Being esomeprazole preferred in 88%, with median dose 1.37 mg/kg/day. No significant differences were observed between responders and nonresponders in demographic variables, familial and personal atopic history, symptoms, or endoscopic findings. Histologically, responders demonstrated significant reductions in eosinophil counts, as well as improvements in basal zone hyperplasia, eosinophilic abscesses, and eosinophil surface layering (all p < 0.005).

This is the first study to assess PPI response in Colombian pediatric EoE patients, demonstrating a response rate consistent with existing literature. Histologic evaluation was identified as the most reliable marker of treatment success, underscoring the critical role of histopathological follow‐up in this disease.