What Is the Difference Between GERD and Eosinophilic Esophagitis?

The Difference Between the GERD and EoE

Discussing chest pain with doctor.
Discussing chest pain with doctor. Universal Images Group/Getty Images

Many of the symptoms experienced by people with GERD and eosinophilic esophagitis (EoE) overlap. While the symptoms are similar, the treatments are different. Are you being unsuccessfully treated for GERD? Another diagnosis to have your doctor consider is eosinophilic esophagitis.

Shared Symptoms Between GERD and EoE

The following is a list of the shared symptoms between GERD and eosinophilic esophagitis:

Diagnosing GERD vs EoE

The differences between GERD and EoE become apparent by looking at the etiology (cause or origin) of the disorders. While GERD is associated with a reflux problem, the cause is not well understood in eosinophilic esophagitis. Research, however, shows that allergies and the immune system's responses are possible causes of eosinophilic esophagitis. While once considered rare, EoE is growing in prevalence. This is likely due to an increased understanding of this disorder and availability of testing.

Both GERD and EoE have involvement of eosinophils in the esophagus. The difference can't really be diagnosed until a biopsy is performed. A small amount of tissue from the esophagus is taken during a procedure called an EGD. Using a high-powered field on a microscope, a count of 15 eosinophils throughout the esophagus is consistent with eosinophilic esophagitis.

A count of less than 10 eosinophils at the distal (lower portion) of the esophagus is consistent with GERD.

Difference in Treatment for GERD and EoE

One of the treatments of choice in GERD is the use of proton pump inhibitors like Protonix, Prilosec, Prevacid, or Dexilant. These medications, however, do not prevent the symptoms in eosinophilic esophagitis; the pH of the stomach is normal in these cases, unlike the pH associated with GERD.

There are not any medications currently approved for treating EoE. However your physician may try using topical steroids as well as dietary management of the symptoms. There are several types of diets that are thought to reduce allergen exposure to the esophagus. The diets differ according to how aggressively foods are removed from your diet. It is thought that by eliminating foods that you are even mildly allergic to will reduce the symptoms. It is always important to involve your doctor when making major dietary changes, as malnutrition can occur if you eliminate important proteins, vitamins, or minerals from your diet.

Important Takeaway

Most GERD-like symptoms are indeed caused by GERD. There may be some people with GERD that are unresponsive to therapy who actually have eosinophilic esophagitis. EoE often has a delayed diagnosis as it is not as common as GERD and the symptoms overlap. Eosinophilic esophagitis is not fatal, and is not known to cause cancer. However malnutrition is a major concern due difficulty swallowing or treatment with eliminating foods from your diet.

Sources:

American Partnership for Eosinophilic Disorder. EoE. Accessed on 12/19/2015 from http://apfed.org/about-ead/egids/eoe/ .

Nonevski, I.T., Downs-Kelly, E. & Falk, G.W. (2008). Eosinophilic esophagitis: An increasingly recognized cause of dysphagia, food impaction, and refractory heartburn. Clevland Clinical Journal of Medicine. Vol. 75(9): pp 623-633. http://www.ccjm.org/content/75/9/623.full]http://www.ccjm.org/content/75/9/623.full.

The Academy of Otolaryngology – Head and Neck Surgery. Fact Sheet: Gastroesophageal Reflux (GERD). http://www.entnet.org/HealthInformation/WhatIsGERD.cfm.​

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