Eosinophilic esophagitis (EoE)

Introduction

Eosinophilic esophagitis (EoE) is a recently recognized chronic illness that is associated with an increased number of an allergic type of blood cell called an eosinophil within the esophagus. Normally, the esophagus should not have any eosinophils. Patients with EoE have an increased incidence of other allergic illnesses such as hay fever, asthma, food allergies, and eczema. Symptoms differ depending on the age group. Feeding disorders, vomiting, and abdominal pain are more common in young children. Older individuals may have difficulty with swallowing, as well as blockages called food impactions that may need to be removed in a medical environment.

What are the symptoms of EoE

• Difficulty swallowing, especially with bread and meats
• Prolonged mealtimes, use of beverages to aid in swallowing
• Food impaction (food gets stuck in the esophagus)
• Nausea and vomiting
• Feeding refusal/intolerance

Diagnosis of EoE

The diagnosis of EoE needs to be made with the help of a procedure called an endoscopy performed by a gastroenterologist. In this procedure, performed under sedation, an endoscope is used to examine the esophagus and take biopsies that are then observed under a microscope. In most cases, there are more than 15 eosinophils per high-power field.

Treatment of EoE

EOE is a chronic condition and lifelong treatment may be required. Treatment may consist of one or more of the following:

• • Food Elimination Diet: Foods may be eliminated based on testing or based on common foods that may trigger EoE. In many cases one or 2 foods such as milk and wheat are initially eliminate. If there is an inadequate response, then further foods can be eliminated.
  • Swallowed Steroids: These are as the medications such as Flovent that may be directly swallowed. Alternatively, a nebulized steroid called budesonide can be swallowed.
  • Acid Supressors: Strong medicines called proton pump inhibitors can be used to treat EoE. Some examples include Prilosec (omeprazole), and Prevacid (lansoprazole). These medications may have an anti-inflammatory effect above and beyond their abilities to suppress acid.

Further support

Eosinophilic esophagitis is a complex disorder that may seem overwhelming at times. Family’s may benefit from participating in support groups, as well as lay organizations such as APFED and CURED.