Eosinophilic Esophagitis

Eosinophilic esophagitis (EoE) is a chronic inflammatory disorder in which an abnormally high amount of eosinophils (a type of white blood cell) build up in the esophagus, irritating the lining. This can result in difficulty swallowing solid and liquid foods and lead to other gastrointestinal symptoms.

Symptoms of Eosinophilic Esophagitis

The symptoms of eosinophilic esophagitis can be very similar to the symptoms of gastroesophageal reflux disease (GERD). Because of this, eosinophilic esophagitis has been historically misdiagnosed up until the early 90s. Signs and symptoms of eosinophilic esophagitis include:

• Dysphagia (difficulty swallowing)
• Abdominal pain
• Persistent heartburn or chest pain that does not respond to antacids
• Food or pills getting stuck in the esophagus after swallowing
• Regurgitation (backflow) of undigested food

In children, major signs of eosinophilic esophagitis include those listed above and additionally:

• Difficulty feeding or eating
• Vomiting
• Failure to thrive (poor growth, malnutrition, and weight loss)

Some serious complications can arise from undiagnosed, untreated eosinophilic esophagitis. Complications include scarring, narrowing, and/or damage to the esophagus. These complications can make swallowing food more and more difficult over time or cause tearing and perforation in the tissue lining the esophagus.

Causes of Eosinophilic Esophagitis

Eosinophils are a normal type of white blood cell in the digestive tract. However, in individuals with eosinophilic esophagitis, an allergic reaction to food or other allergens can cause eosinophil levels to rise. While a specific cause is unknown at this time, researchers believe a genetic component plays a large part in a patient’s likelihood of developing eosinophilic esophagitis. During the past couple of decades, there has been a significant increase in the number of people diagnosed with eosinophilic esophagitis. While this increase was initially thought to be a result of greater awareness and availability of tests, studies now suggest the disease is becoming more common. Rates of eosinophilic esophagitis diagnoses have increased parallel to increases in diagnoses for asthma and allergies.

Diagnosis and Treatment of Eosinophilic Esophagitis

Eosinophilic esophagitis is most commonly diagnosed with an endoscopy and biopsy performed by a gastroenterologist. An endoscopy is an imaging procedure in which a long tube with a small camera on the end is inserted into the esophagus. A few small sections of esophageal tissue will be taken during the procedure and tested for esophageal health. If you receive a diagnosis for eosinophilic esophagitis, your allergist can test you to determine what allergens may be causing the disease to flare. Your allergist may do this through a blood or skin test. Eosinophilic esophagitis is considered a chronic relapsing disease, and most people will require ongoing treatment to control and prevent major flares. Depending on the results of your allergy test(s), your doctor may recommend an elimination diet, in which you eliminate certain foods from your diet to allow your esophagus time to heal and reduce inflammation. Your gastroenterologist or allergist may also recommend medication or a dilation procedure (in which your esophagus is stretched to make swallowing food easier) depending on the severity of your eosinophilic esophagitis.

Next steps

If you are interested in further discussion about your specific needs, Dr. Reshamwala is happy to see you and answer any questions you may have. Please call 512-382-1933 or email clinic@frontierallergist.com to schedule an appointment today! Book an appointment