Eosinophilic Esophagitis

It is not exactly clear what causes EoE, although it seems to be related to other allergic diseases. Most people with EoE have a personal or family history of other allergies such as asthma, hay fever, eczema, and food allergy. For a large number of people, food allergies are the main cause of EoE. Studies have also shown an association between environmental allergies (e.g., dust mites, animal dander, pollen, and mold) and EoE.

Eosinophilic esophagitis can occur in children and adults of all ages.

Symptoms of EoE vary with age. Infants and toddlers may refuse their food or experience failure to thrive, in which they don't grow as expected. School-age children often have persistent abdominal pain, trouble swallowing, or vomiting.

In teenagers and adults, the most common symptoms are difficulty swallowing, especially when eating dry or dense solid foods. The esophagus may become so narrow that food gets stuck or impacted, which requires emergency medical attention.

The diagnosis of EoE is generally made by performing an upper endoscopy and obtaining a biopsy of the esophagus. Because gastroesophageal reflux disease (GERD) also causes eosinophils in the esophagus, this condition must first be ruled out.

In adults, GERD is much more common than EoE. If eosinophils are still present in the esophagus after GERD has been treated, then you most likely have EoE.

After your gastroenterologist has diagnosed EoE, he or she may refer you to an allergist for allergy testing to identify your allergic triggers. Knowing what foods or other allergens are causing your EoE will help the doctor plan your treatment, including changes to your diet.

Treating EoE usually begins by eliminating the foods you are allergic to. Corticosteroids are frequently used to treat EoE when avoiding allergic triggers fails to relieve your symptoms. This may include topical steroids such as fluticasone or budesonide, which are swallowed from an asthma inhaler or mixture. This results in the delivery of the medication directly to the esophagus. Medications for GERD, such as proton pump inhibitors, may also be helpful in managing EoE.