Learn more about the causes and treatment of eosinophilic esophagitis — a digestive disease caused by an allergic reaction.
Eosinophilic esophagitis (e-o-sin-o-FILL-ik uh-sof-uh-JIE-tis) is a chronic immune system disease. With this disease, a type of white blood cell, called an eosinophil, builds up in the lining of the tube that connects your mouth to your stomach. This tube is also called the esophagus. This buildup, which is a reaction to foods, allergens or acid reflux, can inflame or injure the esophageal tissue. Damaged esophageal tissue can lead to difficulty swallowing or cause food to get stuck when you swallow.
Eosinophilic esophagitis has been identified only since the early '90s, but is now considered a major cause of digestive system illness. Research is ongoing and will likely lead to revisions in the diagnosis and treatment of eosinophilic esophagitis.
Esophagitis is inflammation that damages the lining of the esophagus. An endoscope — a long, flexible tube equipped with a camera — may be used to see inside your esophagus. This endoscopic image of eosinophilic esophagitis shows rings of irregular tissue resulting from chronic inflammation. These are known as esophageal rings.
Signs and symptoms include:
Seek immediate medical attention if you experience chest pain, especially if you also have shortness of breath or jaw or arm pain. These may be symptoms of a heart attack.
Make an appointment with your health care provider if you experience severe or frequent eosinophilic esophagitis symptoms. If you take nonprescription medicines for heartburn more than twice a week, see your health care provider.
Eosinophils are a typical type of white blood cells present in your digestive tract. However, in eosinophilic esophagitis, you have an allergic reaction to an outside substance. The reaction may occur as follows:
There has been a significant increase in numbers of people diagnosed with eosinophilic esophagitis in the past decade. At first, researchers thought this was due to an increase in awareness among health care providers and greater availability of tests. However, studies now suggest that the disease is becoming increasingly common, parallel to the increase in asthma and allergies.
The following risk factors are associated with eosinophilic esophagitis:
In some people, eosinophilic esophagitis can lead to the following:
Your health care provider will consider both your symptoms and test results to diagnose eosinophilic esophagitis. This will include determining whether you have gastroesophageal reflux disease (GERD).
Tests to diagnose eosinophilic esophagitis include:
An upper gastrointestinal endoscopy involves inserting a flexible, lighted tube called an endoscope down your throat and into your esophagus. A tiny camera on the end of the endoscope lets your doctor examine your esophagus, stomach and the beginning of your small intestine, called the duodenum.
Eosinophilic esophagitis is considered a chronic relapsing disease, meaning that most people will require ongoing treatment to control their symptoms. Treatment will involve one or more of the following:
Depending on your response to tests for food allergies, your health care provider may recommend that you stop eating certain foods. Cutting out some foods, such as dairy or wheat products, may help to relieve symptoms and reduce inflammation. Sometimes, it may be recommended to limit your diet even more.
If you experience severe narrowing, known as a stricture, of your esophagus, your provider may recommend dilation. Dilation, also called stretching, can help make swallowing easier. Dilation may be used if steroids are not helpful. Or dilation may be a choice to avoid ongoing use of medication.
If you often have heartburn, these lifestyle changes may help reduce the frequency or severity of symptoms:
If you think you have eosinophilic esophagitis, you're likely to start by seeing your regular health care provider. Your provider may recommend that you see a specialist in treating digestive diseases (gastroenterologist) or an allergist.
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared. Here's some information to help you get ready, and what to expect.
Your appointment time is limited, so preparing a list of questions can help you make the most of it. For eosinophilic esophagitis, some basic questions to ask include:
In addition to the questions you've prepared, don't hesitate to ask other questions during your appointment.
Your provider is likely to ask you a number of questions. Being ready to answer them may allow more time later to cover points you want to address.
If you're a parent of a young child, the provider also may ask if your child has trouble feeding or has been diagnosed with failure to thrive.