Eosinophilic (e-o-sin-o-FILL-ik) 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.
The symptoms of EoE vary with age. Infants and toddlers may refuse to eat or not grow properly. School-age children often have decreased appetite, recurring abdominal pain, and trouble swallowing or vomiting. Teenagers and adults can have the same symptoms, but often have difficulty swallowing dry or dense, solid foods. The difficulty swallowing occurs because the esophagus is inflamed, and in severe cases, because the esophagus narrows to the point that food gets stuck. Food firmly stuck in the esophagus is called a “food impaction,” which can be a medical emergency if the food does not go down the esophagus into the stomach or is not vomited up relatively quickly.
Allergists and gastroenterologists are seeing many more patients with EoE. This is due to an increased incidence of EoE and greater physician awareness. EoE is considered to be a chronic condition that can be medically managed, but is not outgrown.
Eosinophils can be found in the esophageal tissue in diseases other than EoE. One common example is acid reflux disease. Other diseases that can cause eosinophils to be in the esophagus must be ruled out before EoE can be accurately diagnosed.
Eosinophilic esophagitis, or EoE, is a mouthful to say, but it’s an increasingly important condition to be aware of. EoE is a chronic allergic reaction in the esophagus, the tube that carries food from your mouth to your stomach. EoE is characterized by the buildup of eosinophils, which are a type of white blood cell that normally aren’t found in the esophagus. This buildup causes inflammation, leading to a range of symptoms.
These symptoms can look quite different depending on the age of the patient. Little ones, like infants and toddlers, might refuse food or struggle to grow as much or as fast expected. School-age kids might complain of frequent tummy aches, have a poor appetite, or find swallowing difficult. Teenagers and adults often report trouble swallowing, especially with dry or solid foods. This happens because the inflamed esophagus can narrow, making it hard for food to pass through easily. In severe cases, food can get stuck, which is called a “food impaction”. This can require urgent medical attention.
Doctors, including allergists and gastroenterologists, are diagnosing more people with EoE these days. This increase is partly because more people are developing the condition and partly due to better awareness among doctors. There is much to be learned about EoE, but we believe that in most cases it doesn’t go away on its own. Options for treatment include anti-inflammatory pills and swallowed liquids, dietary management, and in recent years, an injectable biologic medicine called dupilumab.
EoE cannot be diagnosed without an initial biopsy of the esophagus, typically done by a gastroenterologist. Once you are diagnosed, your Ohio ENT & Allergy provider can help you find the best management option to meet your needs.