Eosinophilic Esophagitis

 

Photo of a man eating in a restaurant close-up view of food going into his mouth

What is eosinophilic esophagitis?

Eosinophilic esophagitis (EoE) is a chronic condition that occurs when an increased number of inflammatory cells called eosinophils cause swelling in the esophagus – the tube that carries food from the mouth to the stomach – making it difficult to swallow.

What are symptoms of eosinophilic esophagitis?

Common symptoms of EoE are:

  • trouble swallowing
  • food getting stuck in the throat
  • needing to drink a large amount of liquid just to get food down

Any of these symptoms suggests you may have eosinophilic esophagitis.

What causes eosinophilic esophagitis?

In some people, EoE can be triggered by food or by environmental allergens such as pollen and mold – but doctors and researchers are not sure what causes it.

Who develops eosinophilic esophagitis?

EoE occurs in both children and adults. It’s common to see it in more males than females, and it’s prevalent in families that have a history of allergic disease.

Ask the Allergist: Eosinophilic Esophagitis

Matthew Greenhawt, MD, is associate professor of pediatrics at the University of Colorado School of Medicine and pediatric allergist and director of the Food Challenge Unit at Children’s Hospital Colorado.

What are some common symptoms of eosinophilic esophagitis?

It depends on age. In infants and young children, symptoms may include refusal to eat food or they may experience poor growth, abdominal pain, reflux and vomiting. In teenagers and adults, there is difficulty swallowing, reflux, chest pain and food getting slightly stuck in the throat.
People with EoE tend to cut their food into tiny pieces, over-chew food, or drink excessive amounts of liquid to get food down.

Many people will experience EoE symptoms for years and never see a doctor. They may come to think it’s normal to have food get slightly stuck in the throat or experience pain as they swallow.

It’s important to note that if food does get stuck in the throat, this is a medical emergency and patients should go to the hospital immediately.

How is EoE diagnosed?

A doctor will perform a biopsy – inserting a small tube, or endoscope, through the mouth to examine the esophagus and stomach and take small tissue samples. There may be visible swelling, lacerations, ulcers or nodules in the esophagus.

How is EoE treated?

There are three ways to treat eosinophilic esophagitis:

  • diet therapy
  • medication
  • a combination of both.

Diet therapy may involve undergoing skin prick and patch testing to identify and remove specific EoE trigger foods from the diet. Another type of diet therapy – generally reserved for children – limits the diet to a non-allergenic, amino acid-based formula.

Compliance to diet therapy is critical – it may be helpful to see a dietician who can find replacement foods to ensure nutritional needs are met.

There is no current FDA-approved medication to treat EoE, although several are in development. Inhaled corticosteroids may be prescribed to help control inflammation and suppress eosinophils. A secondary therapy involves using a proton pump inhibitor – an anti-acid, anti-reflux medication.

Patient Resources

American Partnership for Eosinophilic Disorders (APFED): APFED.org
Campaign Urging Research for Eosinophilic Disorders (CURED): CUREDFoundation.org