Eosinophilic Esophagitis

What is eosinophilic esophagitis and what are the usual symptoms?

Eosinophilic esophagitis (EoE) is an allergic condition that affects the esophagus, the swallowing passage which connects the mouth to the stomach. As the name implies, the hallmark of the condition is the finding of a high number of eosinophils, a type of white blood cell, which leads to inflammation in the esophageal tissue.

Typical symptoms, depending on age, can include:

• Difficulty swallowing, especially solid foods
• Food can become stuck in the swallowing passage
• Chest or abdominal pain
• Reflux that does not go away with medications or vomiting
• In younger patients, difficulty feeding or poor growth and weight gain
• Poor appetite

Who should be evaluated for EOE and what does an evaluation involve?

Previously considered a rare disease, EoE is being diagnosed more often not only due to increased awareness but also due to increased incidence of allergic and immune dysfunction amongst Americans.  EOE is now considered one of the most common causes of difficulty swallowing and food impaction in young adults.

If you experience any of the symptoms or have some of the risk factors associated with EoE, see your doctor for a checkup. Although it is considered to be a chronic condition, allergists and gastroenterologists can help you manage symptoms, live nearly normally with this condition, and minimize long term complications.

A thorough evaluation with a specialist might include:

• A complete history
• A complete physical exam of the swallowing and adjacent structures
• Laryngoscopy and/or an endoscopic evaluation of swallowing, if warranted
• Imaging and/or a swallowing xray, if warranted
• Upper endoscopy with sampling of esophagus tissue may be performed with:
  • topical anesthesia in the clinic – transnasal esophagoscopy (TNE)
  • sedation in the hospital – esophagogastroduodenoscopy (EGD)
• Allergy testing to foods and/or airborne allergens

A treatment plan may include:

• Doing nothing, watchful waiting
• Allergen/food avoidance
• Oral medications taken daily to help control symptoms
• Immunotherapy – desensitization to the offending allergen
• Dilation of the esophagus if it is or becomes constricted and symptoms are significant

Want to learn more? Call DeFatta ENT & Allergy at (715) 828-2368 for more information or to schedule an appointment with our expert swallowing and allergy physicians.