Eosinophilic esophagitis, a once rare condition, is defined by an inflamed esophagus and difficulty swallowing food.

What is eosinophilic esophagitis?

Eosinophilic esophagitis is an allergic reaction to food during which certain white blood cells in the throat get inflamed and make it hard to swallow food. Eosinophils are a type of white blood cell that helps fight off infections and play a role in your body's immune response. In the case of eosinophilic esophagitis, the eosinophils build up and cause inflammation. In severe cases, the esophagus is nearly swollen shut.

Normally your blood doesn't have a large number of eosinophils. Your body may produce more of them in response to an allergic reaction. Patients suffering from eosinophilic esophagitis may be eating food which is causing the eosinophils to go to the esophagus without knowing it. Over time they develop enough inflammation that patients start to exhibit symptoms.

What causes eosinophilic esophagitis?

The main cause of eosinophilic esophagitis is an allergic reaction to food. No certain food seems to be to blame, but it is likely caused by the typical dairy, wheat, egg, soy, nuts and fish allergies.

Eosinophilic esophagitis may be linked to allergens in the air and conditions like asthma. Environmental allergens such as dust mites, pollen, mold and animals could also play a role.

Difficulty Swallowing When Eating

Princess Ogbogu, MD, explains how having a difficult time swallowing food when eating could be due to an allergic condition called eosinophilic esophagitis.

What are the symptoms of eosinophilic esophagitis?

The symptoms of eosinophilic esophagitis vary with age. Infants and toddlers may refuse to eat their food and grow improperly. Children may experience abdominal pain, trouble swallowing and vomiting. Teenagers and adults usually experience difficulty swallowing. Other symptoms include abdominal pains during and after meals and acid reflux that does not respond to medication.

Why choose Ohio State for eosinophilic esophagitis treatment?

The Ohio State University Wexner Medical Center is spearheading trials in conjunction with Nationwide Children’s Hospital, including investigating to see if vitamin D levels influence the occurrence of eosinophilic esophagitis, what food is the most commonly responsible for eosinophilic esophagitis, and if environmental or seasonal factors (pollen) play a role. 

How Ohio State diagnoses eosinophilic esophagitis

Diagnosing eosinophilic esophagitis can be difficult. In most cases, the swelling is very gradual and eosinophilic esophagitis can affect people who are not aware they have allergies.

Your Ohio State University Wexner Medical Center physician may take a detailed history, and order skin and blood tests to diagnose a food allergy. Sometimes a person’s history makes it clear that a particular food is responsible. If not, a blood test checking for specific foods may be used to guide the diagnosis.

Skin testing, done for inhalant or environmental allergens, may suggest a food allergy. A skin test that is negative is pretty reliable in saying that person is not allergic to that food, but a positive skin test doesn’t necessarily mean that food is causing clinical symptoms.

How Ohio State treats eosinophilic esophagitis

Treatment of eosinophilic esophagitis varies depending on the source of the allergic reaction.

If you are diagnosed with specific food allergies after prick skin testing and patch testing, your doctor may remove specific foods from your diet. Your doctor may also prescribe a topical steroid inhaler, which will help reduce swelling and your risk of choking. In some individuals this helps control their eosinophilic esophagitis.

Glucocorticosteroids, which control inflammation, are the most helpful medications for treating eosinophilic esophagitis. Swallowing small doses of corticosteroids is the most common treatment.

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