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Eosinophilic Esophagitis (EoE) Quiz

Eosinophilic esophagitis (EoE) is a recognized chronic allergic/immune condition of the esophagus. The esophagus is the tube that sends food from the mouth to the stomach. In EoE, large numbers of white blood cells called eosinophils are found in the inner lining of the esophagus. Eosinophils can release substances into surrounding tissues that cause inflammation. Normally there are no eosinophils in the esophagus. A person with EoE will have inflammation and increased numbers of eosinophils in the esophagus. The chronic inflammation of EoE leads to symptoms.

Question 1
Which of the following are considered eosinophilic gastrointestinal disorders (EGIDs)?
Eosinophilic esophagitis (EoE)
Eosinophilic gastritis (EoG)
Eosinophilic gastritis (EoG)
Eosinophilic colitis (EoC)
All of the above

All of the above. EoE, which affects the esophagus, is the best known EGID. However, there are other EGIDs that can affect the gastrointestinal tract. These include EoG, which affects the stomach, EoN which affects the small intestine, and EoC, which affects the large intestine (colon). Some patients may have multiple parts of their intestine affected at one time.

Question 2
Which of the following cells are seen in increased numbers in the esophagus of patients with eosinophilic esophagitis (EoE)?
Red blood cells

Eosinophils. Eosinophils, a type of white blood cell that is commonly found in allergic conditions, is found in increased numbers throughout the esophagus of patients with EoE. Typically, there are no eosinophils in the esophagus, but if a pathologist identifies more than 15 eosinophils in a single area under the microscope in a biopsy of the esophagus, a patient is considered to have EoE if other causes have been ruled out.

Question 3
Which of the following can be a complication of long-term eosinophilic esophagitis (EoE)?
Esophageal stricture
Esophageal cancer
Celiac disease
Ulcerative colitis

Esophageal stricture. Strictures develop as a result of scarring of the esophagus. This happens because of long-term inflammation and damage caused by eosinophils in EoE. This can lead to food impactions (food getting stuck in the esophagus). There is no evidence at this time that EoE can lead to cancer or to other gastrointestinal diseases such as celiac disease or ulcerative colitis.

Question 4
Which medication listed below is commonly used to treat eosinophilic esophagitis (EoE)?
Zyrtec (cetirizine)
Singulair (montelukast)
Pulmicort (budesonide)
Zantac (ranitidine)

Pulmicort (budesonide). There are several medications commonly used to treat EoE such as proton-pump inhibitors (PPIs) and swallowed corticosteroids. Examples of commonly used PPIs include Nexium (esomeprazole), Prevacid (lansoprazole), and Prilosec (omeprazole). Examples of swallowed corticosteroids including Flovent (fluticasone) and Pulmicort (budesonide). The only medication to have received full approval for the treatment of EoE from the Food and Drug Administration (FDA) is Dupixent (dupilumab). Antihistamines (e.g. cetirizine), leukotriene blockers (e.g. montelukast), and H2 blockers (e.g. ranitidine) are not typically used to treat EoE.

Question 5
Which of the following foods is considered the most common trigger for eosinophilic esophagitis (EoE)?
Cow’s milk

Cow’s milk. The most common food trigger identified in EoE is cow’s milk. Any food can trigger EoE, but some are more common than others. In addition to cow’s milk, wheat, hen’s egg, and soy are also common triggers. Fish, nuts, rice are less common triggers.

You answered   questions correctly.