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Eosinophilic Esophagitis

What is Eosinophilic Esophagitis

Eosinophilic Esophagitis, or EoE, is a chronic allergic/immune condition that involves inflammation or swelling of the esophagus — the tube that sends food from the throat to the stomach. It occurs when white blood cells called eosinophils gather in the tissue of the esophagus, a place where they usually are not found. This condition can occur at any age, but is most commonly found in Caucasian males. Symptoms can vary with age:

  • Adults and teens will report difficulty swallowing
  • School age children might complain of abdominal pain as well as trouble swallowing
  • Infants and toddlers may refuse food or not grow properly

A major concern with EoE is food impactions, where the esophagus constricts to the point that food gets trapped. This is a medical emergency and requires immediate attention. Allergists and gastroenterologists are seeing more patients with EoE, perhaps due to greater physician awareness.

Diagnosing Eosinophilic Esophagitis

EoE can be difficult to diagnose. Currently the only way to diagnose EoE is with an endoscopy and biopsy of the esophagus. Family history can also help with an accurate diagnosis. A gastroenterologist and an allergist will often work together to make an accurate diagnosis.

Allergies and Eosinophilic Esophagitis

Research suggests that the leading cause of EoE is an allergy or a sensitivity to particular proteins found in foods. A majority of EoE patients have a family history of allergies or asthma. These disorders include allergic rhinitis, atopic dermatitis (hives), food allergy, and asthma.

After the diagnosis of EoE has been made, it is important to have allergy testing. It will provide you, your family, and the gastroenterologist with information so that any allergic aspects of EoE can be properly treated.

Treating Eosinophilic Esophagitis

Depending on the results of the allergy tests, a doctor may recommend that patients remove certain foods from their diet. There are other types of diets that may be suggested; Empiric Elimination and Elemental Diets.

Medical Therapy

No medications are currently approved to treat EoE. However, there are medications that have been shown to reduce the number of eosinophils in the esophagus and improve symptoms.

Glucocorticosteroids, which control inflammation, are the most helpful medications for treating EoE. Swallowing small doses of corticosteroids is the most common treatment.

EoE is a complex disorder and requires that the patient work closely with their gastroenterologist and allergist. Your allergist will determine what role allergies play and will also determine if you need to avoid certain foods. They can also help you manage related problems like asthma and allergic rhinitis.