What is eosinophilic esophagitis?

Eosinophilic esophagitis (EoE) is chronic inflammation of the esophagus — the muscular tube that connects your throat to your stomach — which can lead to swallowing difficulties.

What causes eosinophilic esophagitis?

Sensitivity to certain foods can trigger an immune response that causes inflammation in your esophagus. Over time, this chronic inflammation can lead to narrowing in your esophagus due to the buildup of scar tissue.

Scientists are also exploring whether genetic and environmental factors play a role.

Eosinophilic esophagitis symptoms

In adults, the most common symptom is difficulty swallowing (dysphagia). In severe cases, food may get stuck in your throat, not going down even with water. This may require a visit to the Emergency Department.

Other common symptoms include chest pain and heartburn.

People with this condition frequently have other allergic diseases as well, such as seasonal allergies, food allergies and asthma.

How is eosinophilic esophagitis diagnosed?

While symptoms may suggest eosinophilic esophagitis, an upper endoscopy is needed to confirm a diagnosis.

An upper endoscopy is a test where the doctor passes a flexible tube through the mouth into the esophagus and down into the stomach. Patients are sedated for this procedure so it isn’t uncomfortable.

During the endoscopy, the doctor takes small pieces of tissue that are looked at under the microscope for an increased number of eosinophils, a type of white blood cell that indicate inflammation.

Additional tests may be used to assess the effect of the disease on the function of your esophagus. These include:

  • Esophageal manometry – a flexible catheter with special pressure sensors is passed through the nose into the stomach to check if the esophagus muscles and valves are working normally.
  • Esophagram – as the patient swallows different consistencies of barium, a medication that coats the esophagus, pictures and videos are taken with an X-ray machine to look for reflux and areas of narrowing.
  • Functional luminal impedance planimetry or EndoFLIP – a thin, flexible tube with a small camera at the end is passed through the esophagus to see how well the esophagus valves and muscles are working.

Eosinophilic esophagitis treatment

Treatment is personalized for each patient and may combine different therapies. Medicine may include corticosteroids, like fluticasone and budesonide, or proton pump inhibitors to reduce the inflammation.

Diet modification is also a treatment option and involves eliminating one to six of the most common foods that trigger inflammation, such as milk and wheat.

Patients who develop narrowing of the esophagus may need to have it stretched periodically. This simply requires an upper endoscopy.

Why choose Ohio State for eosinophilic esophagitis care?

  • We provide an individualized approach to the treatment of this disorder, with care provided by a team of experts including gastroenterologists who specialize in esophageal diseases, nutritionists and allergy specialists.
  • The Ohio State University Wexner Medical Center is a leader in minimally invasive procedures, and patients can access a wide range of the latest available treatment options.
  • We partner with Nationwide Children’s Hospital to provide a smooth transition of care for our pediatric patients with EoE into an adult care setting.
  • The Ohio State Wexner Medical Center is nationally ranked in gastroenterology and GI surgery and consistently ranks as the top hospital in the Columbus metro area according to U.S. News & World Report.
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