Eosinophilic Esophagitis in Adults

How Eosinophilic Esophagitis can have a huge impact on the quality of life in Adults

Eosinophilic Esophagitis (EE) is a serious illness effecting an individuals quality of life and in more serious cases, resulting in invasive medical interventions. Most often discovered after someone begins to experience difficulty swallowing, this disorder is classified by irritation, inflammation, and sometimes swelling of the esophagus. Though the disease is not limited to a specific age range, diagnosed cases of Eosinophilic Esophagitis in adults are on the rise.

This type of esophagitis is always the result of an excessive build-up of eosinophils in the tissues of the esophagus. Eosinophils are a type of white blood cell normally associated with immune system responses to parasitic infections. They combat invasive parasites through the release of toxins and special destructive enzymes. When larger than normal quantities of these cells accumulate, the toxins they contain can have damaging effects on the surrounding tissues. This build-up is thought to be closely related to an auto-immune system misinterpretation of allergens in the body.

Most often, Eosinophilic Esophagitis in adults is diagnosed in patients with histories of multiple allergic reactions, often serious reactions, and usually to food related allergens. The trouble swallowing which often leads esophagitis sufferers to seek help is caused by a number of eosinophilic factors. Sometimes difficulty swallowing is due simply to the excessive numbers of eosinophil cells in the esophagus. These cells attach to the tissues of the esophageal wall and when present in large enough numbers can create the perception of an obstruction in the throat that is most aptly felt when swallowing. Difficulty swallowing can also be caused by actual damage to the esophageal tissues. Irritation and inflammation can cause ridges, fissures, or rings of impacted tissue that are easily felt by the patient and result in trouble swallowing solid foods.

Over time, patients with this illness will experience varied levels of reaction, likely dependent on the introduction of allergens to which the eosinophils are responding. Each episode of increased inflammation can lead to tissue damage and scarring causing not only short term discomfort but long-term trouble swallowing that can only be temporarily alleviated through a medical procedure designed to break away the physical obstructions.

Though most adults with eosinophilic esophagitis seek treatment after prolonged periods where they have trouble swallowing, Eosinophilic Esophagitis has a wide range of symptoms including:
  1. abdominal pain
  2. esophageal pain when swallowing (odynophagia)
  3. chest pain in and around the breast bone
  4. heartburn
  5. nausea
  6. vomiting
  7. weight loss (or inability to add weight)
  8. decreased appetite
In adults the primary symptom is difficulty swallowing followed by esophageal pain, chest pain, and heartburn. Sufferers of EoE often report that when they have trouble swallowing it can feel as if they are choking, that the food swallowed can go neither down the esophagus or come back up, and that they have a difficult time breathing through the episodes.

There are no cures for this illness or for the trouble swallowing the illness creates. To diagnose Eosinophilic Esophagitis individuals must undergo an Endoscopy with visual assessment and biopsy of esophageal tissue. Once diagnosed patients may be advised to track types of food that result in a reaction after eating. This may or may not indicate the food is creating the allergic reaction; however, overtime patterns can be identified that enable people to avoid ingesting substances that result in feelings of difficulty swallowing.

Medical treatments available rely heavily on the use of steroid consumption, in the form of swallowed or inhaled medications. These work by reducing the inflammation of the esophageal tissues and decreasing the trouble swallowing normally experienced. There can be complications when used for extended periods and the treatment time frame is usually dictated by the ongoing risks of these complications occurring. When diet modification and steroid treatments are no longer enough to combat difficulty swallowing for those with Eosinophilic Esophagitis, physicians may recommend an esophageal dilatation.

Esophageal dialations are conducted when difficulty swallowing has become so severe that the patient has a food obstruction or when the discomfort level has significantly impacted one’s ability to eat enough to adequately sustain the body. A specialist will utilize an endoscope with a variety of attachments to conduct a visual examination looking for food blockages, scar tissue, and excessive deposits of deteriorating eosinophils any of which can create trouble swallowing. During the procedure the physician will break away constricting bands of tissues and expand the esophagus to decrease swallowing difficulties and provide relief.

Eosinophilic Esophagitis in adults is a chronic illness. Though no cures exist it is important that people who have trouble swallowing when eating a normal meal seek medical advice. If the difficulty swallowing is related to esophagitis it will only escalate in severity without intervention causing greater physical impact and more serious consequences.

For more detailed information check out the list of topics about eosinophilic esophagitis.

You can also ask questions and communicate with others about the disorder by becoming a member of the free Eosinophilic Esophagitis Forum.