Table 1

Endoscopic features of eosinophilic oesophagitis, classification and grading

Grade 0Grade 1Grade 2Grade 3
Major features
Oedema (decreased vascular markings, mucosal pallor)Absent; distinct vascularity presentLoss of clarity or absence of vascular markings
Fixed rings (concentric rings, corrugated oesophagus, corrugated rings, ringed oesophagus, trachealisation)NoneMild—subtle circumferential ridgesModerate—distinct rings that do not impair passage of a standard diagnostic adult endoscope (outer diameter 8–9.5 mm)Severe—distinct rings that do not permit passage of a diagnostic endoscope
Exudates (white spots, plaques)NoneMild—lesions involving <10% of the oesophageal surface areaSevere—lesions involving >10% of the oesophageal surface area
Furrows (vertical lines, longitudinal furrows)AbsentPresent
StrictureAbsentPresent (specify estimated luminal diameter)
Minor features
Crepe paper oesophagus (mucosal fragility or laceration upon passage of diagnostic endoscope but not after oesophageal dilation)AbsentPresent
Narrow calibre oesophagus (reduced luminal diameter of the majority of the tubular oesophagus)AbsentPresent
  • Adapted from Hirano et al, 2013.29