What is Eosinophilic Esophagitis?

About Eosinophilic Esophagitis

Eosinophilic Esophagitis is a disease that directly affects the esophagus. This ailment, also known as EE or EoE, is one that is steadily becoming more and more widespread. Eosinophilic Esophagitis has increasingly become recognized by different physicians such as allergists, gastroenterologists (GI specialists), pediatricians and internists. While it is true that the amount of people known to have EoE has certainly increased, it is still a considerably rare disease that is often misdiagnosed as gastroesophageal reflux disease, or behavioral problems.

For many people, EoE has been completely overlooked because of the unfamiliarity of the disease. However as aforementioned, it is often misdiagnosed as GE reflux disease because of the similarities between the symptoms. These symptoms can include: difficulty swallowing (dysphagia), vomiting (often with meals), failure to gain weight, heartburn, discomfort when swallowing (odynophagia), food impaction, the unwillingness to eat, abdominal, throat, or chest pain, and coughing.

Unfortunately, Eosinophilic Esophagitis is frequently seen as behavioral issues, or simple flaws that people decide are not that serious. Many come to these conclusions because some of the signs of Eosinophilic Esophagitis do not seem drastic enough for them to believe that they or a family member is unknowingly suffering from a disease. For instance, parents often figure that their child just refuses to chew their food carefully or slow down when they eat. Because these are traits that many children share, parents do not think much of it; they certainly do not realize that their child has a disease preventing them from eating properly and comfortably. In other cases, especially regarding adults with Eosinophilic Esophagitis, they just decide that the symptoms are a personal flaw that they can live with.

Further serious issues regarding the diagnosis of Eosinophilic Esophagitis is that numerous physicians believe that their patients are not taking their reflux medication diligently, therefore causing their symptoms to worsen. Sometimes, physicians think that their patients are actually exaggerating their symptoms, not realizing that they may have Eosinophilic Esophagitis. In addition, recognizing that a patient does indeed have Eosinophilic Esophagitis can be difficult because the only true method of confirming this ailment is through an Esophageal Biopsies and Upper Endoscopy (EGD); this procedure is used to determine whether the numbers of eosinophils has increased.

Once a person has been diagnosed with Eosinophilic Esophagitis, hope is not lost; this is a treatable disease. If a person has EoE due to allergies (this is the most common way in which children experience EoE) their physician should begin by finding out which foods they are allergic to by taking different allergy tests. There are a few allergy tests including skin prick testing, atopy patch testing, and blood testing to identify IgE-mediated allergies. Once the foods the patient is allergic to have been eliminated from their diet, the Eosinophilic Esophagitis symptoms should improve and the eosinophilic inflammation in the patient’s esophagus heals. In addition, there are allergy related dietary options such as the Six Food Empiric Elimination Diet that inhibit common food allergens, and the amino-acid based Elemental Diet. Both of these have proven to be successful in the treatment of Eosinophilic Esophagitis. There are also medical therapies such as Swallowed Inhaled Steroids that doctors feel their patients should go through. This is the most common drug therapy, and the two main types of these steroids are flucticasone (Flovent) inhalers and budesonide (Pulmicort).

Eosinophilic Esophagitis is a disease that can affect people in various ways. Since everyone is different, certain treatments may work well for some people and not for others. Once a person has been diagnosed with Eosinophilic Esophagitis, it is imperative for their allergist or gastroenterologist to decipher which therapy is best for their unique case.