Eosinophilic Esophagitis (EE, EoE)
Eosinophilic esophagitis, also known as EE or EoE, is an allergic inflammatory disease and typically chronic disorder that affects from one to four of every 10,000 people in the United States. It is a recently recognized disease with increasing diagnoses, resulting in part from growing awareness of the condition.
Eosinophilic esophagitis symptoms
People of all ages can be affected by eosinophilic esophagitis, with symptoms that may vary by age range and individual differences.
Those who suffer from eosinophilic esophagitis have a large number of eosinophils—a type of white blood cell that is normally found in small numbers in the blood—and inflammation in the esophagus. A large number of eosinophils in the esophagus may result from a food allergy reaction, acid reflux, or airborne allergens, which can contribute to inflammation, or injury to the esophageal tissue.
An estimated 50 percent of patients with eosinophilic esophagitis also have seasonal allergies or asthma. Many others also have food allergies or eczema. Some patients note a seasonal flare up of the condition, typically in the spring and in the summer.
Researchers studying eosinophilic esophagitis have identified a possible environmental link to mold, and theorize that both genetic and environmental factors play a role in the development of the disease.
Eosinophilic esophagitis in children
In infants and toddlers, eosinophilic esophagitis can cause irritability, problems with feeding, and poor weight gain. In older children, the disease can cause reflux, regurgitation, vomiting, and/or stomach pain. Teens and adults with eosinophilic esophagitis may also experience these symptoms, in addition to chest pain and trouble swallowing foods—feeling like a food is "stuck" in the esophagus. They may also find themselves drinking a lot of fluids to finish a meal or be unable to finish a meal because they feel full midway through.
Eosinophilic esophagitis treatment
After a diagnosis of eosinophilic esophagitis, in many cases food allergy testing is performed and counseling provided on foods to avoid if food allergy is diagnosed. It is important to note that food-related reactions may not be immediate; some patients may find that the esophagus becomes inflamed by an offending food days or weeks after eating it. Dietary changes can significantly and immediately improve the symptoms of eosinophilic esophagitis.
Currently there are no medications known to cure eosinophilic esophagitis, but some medications may suppress eosinophil accumulation, relieve damage to the tissue in the esophagus, and alleviate symptoms. Oral or topical steroids may be prescribed. Because eosinophilic esophagitis treatment plans are individualized, patients with eosinophilic esophagitis should work closely with an allergist, and if necessary, a gastroenterologist, to implement a specific treatment plan that works best for them.
How We Can Help
Proper diagnosis of eosinophilic esophagitis should be confirmed by an allergist and gastroenterologist. Our allergist, Dr. Judge will take a clinical history and may perform food allergy testing. Gastroenterologist might do upper endoscopy to get a close look at the esophagus to check for inflammation. Sometimes eosinophils may be present in an esophagus that appears normal. A biopsy of the esophagus must be performed to confirm diagnosis.