Eosinophilic Esophagitis (EoE) is an allergic inflammatory disease characterized by a large number of white blood cells called eosinophils that cause inflammation in the lining of the esophagus (the tube that connects the mouth and stomach). Clinical and genetic research is ongoing. EoE is increasingly diagnosed in children and adults. It is recognized as a rare disease seen with increasing prevalence estimated to be 1:2000. Although EoE is more common in men, it occurs in both men and women; in our practice, we see adults suffering from this condition.
Our practice is at the forefront of treating this newly recognized condition that is on the rise.
EoE most commonly associated with people who suffer from other allergic diseases such as environmental allergies, allergic rhinitis (hayfever), asthma, food allergies, and/or eczema.
- Reflux not improved by low acid diet + acid-blocking medications
- Difficulty swallowing
- Food impactions (food gets stuck in throat/esophagus)
- Chest tightness/pain
- Feeding refusal and secondary inability to gain weight
The only way to definitively diagnose EoE is through endoscopy with biopsies, performed by a gastroenterologist. The endoscopy is often performed after treatment with reflux medications and a low acid diet, which have failed to relieve symptoms. The endoscopy is used to identify eosinophils from a biopsy of the esophagus under a microscope. At this time the agreed-upon number of eosinophils (>15 per high power field under the microscope) suggests a diagnosis of EoE.
Once confirmed, allergy testing (skin prick) is helpful in identifying offending food allergens that can be removed from the diet.
Your Gastroenterologist and Allergist will collaborate and formulate an individually tailored treatment strategy. At present, the main treatments recommended are dietary management, proton pump inhibitor medication, and swallowed topical corticosteroids to control inflammation and suppress the eosinophils.
How We Can Help
The diagnosis and treatment of eosinophilic esophagitis require a multidisciplinary team approach involving gastroenterologists, allergists, and nutritionists. This newly identified disease, diagnosis, and treatment are continually evolving.