Eosinophilic esophagitis (EoE) is a chronic allergic/immune condition affecting the esophagus, or the tube leading from the mouth to the stomach. It is sometimes referred to as “asthma of the esophagus,” because, like asthma, there is chronic inflammation, or swelling, thought to be triggered by an allergic/immune system reaction. In EoE, large numbers of white blood cells called eosinophils are found in the tissue of the esophagus. Normally there are no eosinophils in the esophagus.
EoE can occur at any age. The symptoms of EoE vary with age, and it is thought to be a chronic, progressive disorder. Infants and toddlers often present with feeding refusal and trouble swallowing, often leading to poor weight gain and growth. School-age children typically have recurring abdominal or chest pain, trouble swallowing or vomiting. Teenagers and adults most often have difficulty swallowing. The esophagus can narrow to the point that food becomes impacted, or stuck, which is a medical emergency. In many cases, symptoms are suggestive of gastroesophageal reflux (“acid reflux”), but do not respond to standard treatment for reflux.
As compared to just ten years ago, many more patients today are being diagnosed with EoE. This is due to an increase in the frequency of EoE and greater awareness. The diagnosis is made with endoscopy and biopsies, performed by a gastroenterologist, or digestive health specialist. Treatment options include anti-inflammatory medications and dietary restrictions. As most patients with EoE are atopic (have other allergic conditions), allergists and gastroenterologists work together to determine the best treatment plan.
Testing for food and environmental allergies may identify triggers in EoE, and optimal management of co-existing allergic disorders may improve the outcome for the EoE patient. The Board Certified Allergists at AAIR of Charlotte offer the full range of tests for food and environmental allergies. We have extensive experience with EoE in children and adults, and enjoy a good working relationship with adult and pediatric gastroenterologists in our community.
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