Eosinophilic esophagitis (EoE) is a chronic condition caused by the immune system’s reaction to allergens in the environment and various foods. The immune system fills the esophagus, the tube leading from the mouth to the stomach, with inflammatory cells, including a type of white blood cell called eosinophils.
While there is no cure for EoE, it’s important that you work with a trained specialist to ease its symptoms so they don’t cause more serious complications.
Symptoms & Diagnosis
Every person’s experience with EoE is unique, but common symptoms include:
- Heartburn
- Chest pain
- Regurgitation (spitting up) of undigested food
- Trouble swallowing
- Food getting stuck in the esophagus
- Vomiting
- Nausea
- Abdominal pain
Risk factors for EoE include:
- Family history
- Gender. The condition is more common in men.
- Climate. People living in cold or dry climates are more likely to have EoE, which is diagnosed more between spring and fall when levels of pollen and other environmental allergens are higher.
- Asthma and allergies
To diagnose EoE, your specialist will conduct a complete physical exam, talk to you about your symptoms and send you for one or more of these tests:
- Upper endoscopy. We will insert a tube with a camera down your throat to get a good look at the inside of the esophagus. Your specialist may take a tissue sample (biopsy) to examine under the microscope for eosinophils.
- Blood tests. We’ll check for high eosinophil levels and other thing that are signs of an allergic reaction. This can also help us pinpoint the allergen.
- Barium swallow test. You will drink a special liquid containing barium, which will show up on x-rays we take of the esophagus when you swallow.
Treatment Options
Treatment for EoE can start as simply as making dietary changes, but other changes and medication might be needed to control the condition.
We know that not seeking care for EoE can cause more serious complications such as:
- Scar tissue build-up in the esophagus. This narrows the space for food and drink to pass to the stomach and can leave you feeling like food is stuck. It can also cause food to get stuck.
- Esophagus damage. It’s possible that inflammation or regurgitation can cause tears in the tissue lining your esophagus.
Because EoE is a chronic condition, you will likely need ongoing treatment to ease the symptoms and long-term effects on your digestive system. Treatment can include:
- Dietary changes. If testing shows you have food allergies, you should stop eating those foods. Our nutritionist can help you create a healthy eating plan.
- Medication. There is a variety of options for people with EoE and you may need to try one or more before finding one that works best for you. There are proton pump inhibitors (PPIs) that block acid production, liquid steroids and monoclonal antibodies that block the inflammatory effect of eosinophils in the esophagus.
If your esophagus has narrowed as a result of EoE, you may need a procedure called dilation in which we insert a surgical balloon down your throat to the affected area and inflate it to stretch the tissue.
Living with the Condition
Members of your care team are here to help you live a full life with EoE. In addition to your specialist, our nutritionists can tailor dietary plans to meet your specific needs and behavioral health counselors can provide guidance as you live with a chronic disease. Our goal is always to provide you and your family support and expert medical care at every step of your journey.