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.
- 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
- Environmental allergies
- Food allergies
- IgE and non-IgE food allergies
- Genetic predisposition in some families
- Upper endoscopy (placement of a lighted tube into the mouth, esophagus and stomach)
- Biopsies of the large intestine are necessary to make the diagnosis. Eosinophils causing injury on biopsy, in the context of symptoms consistent with EC
- Endoscopy may show erosions, ulcers or irritated areas of the large intestine
- Biopsy: Eosinophils invading the large intestine. Biopsy may show chronic inflammation. No consensus recommendations on definition or diagnosis.
- Allergy testing may be helpful in some patients to identify and remove offending food allergens.
- 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)
- 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
Author: Wendy Book MD, updated 9-08-2011, reviewed by Dr. Jonathan Markowitz
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