Eosinophilic Esophagitis (EoE)
What is eosinophilic esophagitis?
Eosinophilic esophagitis (EoE) is a chronic, allergic inflammatory disease of the esophagus. It occurs when a type of white blood cell, an eosinophil, accumulates in the esophagus as a reaction to food or environmental allergens. The buildup of eosinophils can cause injury and inflammation, which over time can cause scarring and narrowing in the esophagus.
What are the symptoms of eosinophilic esophagitis?
Patients with eosinophilic esophagitis may experience difficulty swallowing or food getting stuck in their esophagus. Risk factors for EoE include a history of allergies, asthma, atopic dermatitis, family history of EoE, and people living in cold and dry climates. Eosinophilic esophagitis may develop at any point in the lifespan.
How is eosinophilic esophagitis diagnosed?
Eosinophilic esophagitis is diagnosed through upper endoscopy with biopsy of the esophageal mucosa. The upper endoscopy will allow the doctor to inspect the lining of your esophagus for inflammation, rings, and linear furrows that are characteristic for EoE. Your doctor is likely to take biopsies of the lining of the esophagus, and a pathologist will examine the tissue for an eosinophil count to confirm the diagnosis of EoE. Your doctor may also perform a dilation (or “stretch”) of the esophagus during the upper endoscopy to increase the lumen diameter of the esophagus to make swallowing easier.
How is eosinophilic esophagitis treated?
Once eosinophilic esophagitis is diagnosed, there are several treatment options beyond dilations for patients to consider for the long-term management of this chronic disease. Sometimes diet changes (elimination diets) and allergy testing can be helpful to identify allergens triggering EoE. Medication options, such as proton pump inhibitors and topical steroids, can also be useful to reduce inflammation of the esophagus for both long-term and short-term management of EoE. Newer therapies are coming, which include infusions of immunoglobulins and other IV medications.
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