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Eosinophilic Esophagitis Quick Facts

Eosinophilic Esophagitis

 

Eosinophilic esophagitis is an increasingly common disease in which a type of white blood cell, the eosinophil, causes injury and inflammation to the esophagus (the tube that connects the mouth to the stomach). Eosinophilic esophagitis is reported to be more common in males, and may affect both adults and children.

 

Symptoms:

  • Reflux that does not respond to acid blocking medicines
  • Difficulty feeding and/or gaining weight
  • Poor growth
  • Difficulty swallowing
  • Food sticking in the throat (food impaction)
  • Chest pain

 

Associated Diseases:

  • Environmental allergies
  • Asthma
  • Food allergies

 

Causes:

  • IgE and non-IgE food allergies
  • Genetic predisposition in some families

 

Diagnosis:

  • Upper endoscopy (placement of a lighted tube into the mouth, esophagus and stomach)
  • Biopsies of the esophagus are necessary to make the diagnosis. Eosinophils numbering > 15 per high powered field despite therapy with an acid blocking medication, in the context of symptoms consistent with EoE

 

Findings:

  • Endoscopy may show furrowing, rings, white patches or be visually normal
  • Biopsy: Eosinophils invading the esophagus. Biopsy may show chronic inflammation. Eosinophils should be carefully sought when chronic inflammation is seen. Recent consensus recommendations are > 15 per high powered field.

 

Allergy Testing

  • Allergy testing may be helpful in patients to identify and remove offending food allergens.

 

Treatment:

  • Elimination diet (allergy test directed or empiric “six-food elimination”)
  • Topical Steroids
  • Avoid known allergens or triggers
  • Elemental diet (avoid all food protein and obtain all nutrition from a special formula)

 

Prognosis:

  • Good response to treatment in most
  • Recurrent episodes can occur. Untreated episodes may cause scar tissue to form in the esophagus and cause problems with swallowing

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Author: Wendy Book MD, updated 9-08-2011, reviewed by Dr. Jonathan Markowitz
© American Partnership for Eosinophilic Disorders 2011. Content may not be reproduced in part or in whole without express written consent from APFED. Contact us Mail@apfed.org