Eosinophilic Esophagitis (EoE)
Overview
Eosinophilic (ee-uh-sin-uh-fil-ik) Esophagitis (EoE) is an allergic condition causing inflammation of the esophagus. The esophagus is the tube that sends food from the throat to the stomach.
People with EoE have a larger than normal number of eosinophils in their esophagus. Eosinophils are a type of white blood cell that may cause inflammation in the esophagus and in other parts of the gastrointestinal tract.
Most research suggests that the leading cause of EoE is an allergy or a sensitivity to particular proteins found in foods. Many people with EoE have a family history of allergic disorders such as asthma, rhinitis, dermatitis or food allergy.
Symptoms & Diagnosis
Symptoms
The most common symptom of EoE in adults is difficulty and sometimes pain in swallowing solid foods. This is due to inflammation of the esophagus.
Other symptoms include:
• Heartburn
• Vomiting (often during meals)
• Abdominal pain
• Chest pain
In children, EoE symptoms can include poor growth, weight loss, a poor appetite or even refusing to eat.
Diagnosis
In order to diagnose EoE, a doctor will perform an endoscopy and a biopsy of the esophagus. This is usually done after medications to control acid reflux have failed to improve symptoms.
Diagnosing the condition is often a coordinated effort between a gastroenterologist and an allergist / immunologist. An allergist will determine the role that allergies may play in EoE by performing allergy testing to diagnose which specific allergens may be involved with your EoE.
Treatment & Management
If tests performed by an allergist / immunologist indicate that an allergy is involved with your EoE condition, then your allergist will work with you to develop a plan to avoid allergens that trigger your symptoms.
In the case of food allergies this means eliminating the food protein from your diet.
No medications are currently FDA approved for specifically treating EoE. New forms of therapy are being investigated and may provide significant relief in the future. Under the care of a physician, some individuals with EoE are currently being treated with swallowed steroid from an asthma inhaler or nebulizer.
The American Partnership for Eosinophilic Disorders (APFED) helps patients and their families cope with eosinophilic gastrointestinal disorders.
Additional Information
Eosinophils and IL-9 promote mast cell accumulation in pediatric eosinophilic esophagitis »
A new syndrome: Eosinophilic esophagitis with connective tissue disorder (EoE-CTD) »
Food avoidance and prolonged drug-free remission in adult eosinophilic esophagitis »
Blood test identifies asthma patients with increased airway eosinophils »
Skin testing has limited usefulness to plan dietary therapy in adult eosinophilic esophagitis »
Can we determine appropriate foods to eliminate to treat Eosinophilic Esophagitis? »
Approach to dietary therapy in patients with eosinophilic esophagitis who demonstrate positive specific IgE tests to foods »