What Is Eosinophilic Esophagitis?

Woman experiencing swallowing difficulties.
Woman experiencing swallowing difficulties. BSIP/UIG/Getty Images

Eosinophilic esophagitis (EoE) is an autoimmune condition of the esophagus. It is characterized by infiltration of the tissue of the esophagus by eosinophils, a type of white blood cell. The cause of eosinophilic esophagitis is not entirely clear but it appears to be related to allergies (possibly to certain foods). The presence of eosinophils in the esophagus causes inflammation, and can lead to fragility of the tissue lining the stomach and the esophagus.

It can also cause scar tissue to develop in the esophagus and stomach.

Eosinophilic esophagitis occurs in children and adults of all ages. It is a relatively newly identified condition that was thought to be rare but is being diagnosed more frequently.  The condition seems to be most common among caucasion males, although it is diagnosed in both sexes and in individuals of all races. It also occurs mainly in developed countries. Eosinophilic esophagitis is associated with other conditions including allergies, celiac disease and Helicobacter pylori infections. It may be more common in cold, dry climates, suggesting environmental factors play a role in the cause of eosinophilic esophagitis.

Symptoms of Eosinophilic Esophagitis

Symptoms of eosinophilic esophagitis may include:

  • pain in the chest or stomach
  • decreased appetite
  • anemia
  • failure to thrive (infants and small children)
  • refusal to eat

Your symptoms may be different depending on your age. For example, infants often refuse to eat, children are more likely to have nausea, vomiting, weight loss and anemia. Symptoms such as difficulty swallowing, heartburn, chest or abdominal pain are more common in older children and adults.

Diagnosing Eosinophilic Esophagitis

The diagnosis of eosinophilic esophagitis requires an endoscopy. This is usually done in a hospital or surgical center. After giving you sedative medications, your doctor will pass an endoscope (a flexible tube with a light source and camera at the end) through the mouth and into your esophagus. The esophagus can be inspected visually, and biopsies (tissue samples) can be obtained from the upper and lower portions of the esophagus. The tissue samples can then be examined for the presence of eosinophils.

You will need an hour or so to recover from the sedating medications you are given for this procedure. Someone will need to drive you home. Most people do not have much pain afterwards but you may feel a bit gassy and bloated.

Treatment of Eosinophilic Esophagitis

Treating underlying allergies, particularly food allergies can be beneficial in the treatment of eosinophilic esophagitis. You may want to see a doctor who specializes in diagnosing and treating allergies (called an Immunologist).

Elimination diets, where foods that are known to frequently cause allergic reactions are eliminated one at a time, can be useful for some people.

Eosinophilic esophagitis is sometimes treated through the use of aerosolized corticosteroids, medications that suppress the function of the immune system. Some people with eosinophilic esophagitis respond to a group of medications used to treat GERD called proton pump inhibitors.

Source:

 

American Academy of Allergy Asthma & Immunology. Eosinophilic Esophagitis (EoE). Accessed: October 13, 2016 from http://www.aaaai.org/conditions-and-treatments/related-conditions/eosinophilic-esophagitis

American Partnership for Eosinophillic Disorders. About EoE. Accessed: December 12, 2015 from http://apfed.org/about-ead/egids/eoe/

Medscape. Eosinophic Esophagitis. Accessed: October 13, 2016 from http://emedicine.medscape.com/article/1610470-overview#a2

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