Eosinophilic Esophagitis | Digestive Health Program | Loyola Medicine

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Eosinophilic Esophagitis

Overview and Facts about Eosinophilic Esophagitis

Eosinophilic esophagitis (EoE) is a digestive health disorder that results when white blood cells (called eosinophils) build up in your esophagus, causing inflammation and pain. When the esophagus – the muscular tube that connects your mouth to your stomach – becomes inflamed, you may have difficulty swallowing and food may get stuck in your throat. Although the condition is rare, it’s often misdiagnosed as acid reflux or GERD.

Symptoms and Signs of Eosinophilic Esophagitis

When eosinophilic esophagitis flares up, you may notice multiple symptoms. In infants and toddlers, who can’t express their discomfort, you may notice issues with feeding, poor weight gain, or vomiting. In older children and adults, the most common signs and symptoms of EoE include:

  • Abdominal pain
  • Chest pain
  • Difficulty swallowing
  • Food that gets stuck in your throat
  • Heartburn
  • Poor appetite
  • Reflux that doesn’t improve with medication
  • Vomiting

Causes and Risk Factors of Eosinophilic Esophagitis

Although the root causes of eosinophilic esophagitis are unknown, it’s believed to be an immune system malfunction that may result from an allergic reaction to certain foods or environmental stimuli. There may also be a genetic influence.

Although anyone can develop EoE, it’s most common among:

  • Caucasians
  • Men
  • Those with allergic conditions including eczema, asthma, and hay fever

Tests and Diagnosis of Eosinophilic Esophagitis

To diagnose eosinophilic esophagitis, your doctor may take a full medical history and review your symptoms. With an upper gastrointestinal (GI) endoscopy, your doctor can look at your esophagus for signs of EoE, which includes white spots, rings, narrowing, or inflammation. They may also do a biopsy, where they take a small sample of cells to test. If this sample has a high number of eosinophils, you have EoE. To rule out other conditions, your doctor may order blood tests as well.

Treatment and Care for Eosinophilic Esophagitis

Eosinophilic esophagitis is a chronic condition and, therefore, doesn’t have a cure, although its symptoms can be managed with dietary changes and medication. Depending on the severity of your symptoms, your doctor may recommend:

  • Acid suppressors to help reduce reflux symptoms
  • An elimination diet, which avoids certain foods to see if your symptoms reduce
  • An elemental diet, which eliminates all proteins, replacing the amino acids
  • Steroids to control inflammation

If none of these treatments reduce your symptoms, your doctor may recommend dilation, where they stretch the muscles of your esophagus, making it easier for you to swallow food.