A chronic immune system condition in which a type of white blood cell (called eosinophils) builds up in the esophagus lining (the tube that carries the food from the mouth to the stomach) is called Eosinophilic esophagitis. This buildup is often a reaction to foods, allergens, or acid reflux that may lead to inflammation or damage to the esophageal tissue. Therefore, you may experience swallowing problems or food may get stuck in the esophagus.
This condition has been detected only since the early ‘90s however it is considered a major cause of digestive system conditions. While there are several treatment options for this condition, research may lead to some revisions in the diagnosis and treatment.
Symptoms
The symptoms appear differently among people. Check some symptoms that occur in adults with eosinophilic esophagitis:
- Chest pain (angina)
- Backflow of undigested food (also called regurgitation)
- Impaction (it occurs when food gets stuck after swallowing)
- Dysphagia (swallowing problems)
Moreover, children with this condition may experience other symptoms. These include:
- Dysphagia
- Failure to thrive (such as poor growth, malnutrition, and weight loss)
- Impaction
- Abdominal pain
- Vomiting
- Difficulty feeding (in infants) and eating (in children)
- No response to GERD (gastroesophageal reflux disease) medicines
Immediately contact your healthcare professional if you experience pain in the chest, jaw, or arm and shortness of breath because these symptoms may indicate a myocardial infarction (heart attack).
Causes
However, eosinophils are a typical white blood cell type present in the digestive tract. The condition happens due to an allergic reaction to outside substances. For example:
- Esophagus reaction – An allergic reaction may occur in the esophagus due to pollen, food, or other allergens.
- Eosinophils multiplication – Inflammation of the esophagus lining may also happen due to eosinophils multiplication.
- Esophagus damage – Inflammation and irritation of the esophagus may lead to scarring and narrowing, or the formation of excessive fibrous tissue in the lining of the esophagus.
- Dysphagia and impaction – Difficulty swallowing or food getting stuck when you swallow may occur in people with eosinophilic esophagitis.
Nowadays, the number of people with this condition significantly increases compared to the past decade. However, doctors believe the number of people who suffer increases due to the greater availability of tests that can determine whether a person has eosinophilic esophagitis or not.
Risk Factors
The following factors may increase your risk of developing this esophagus condition. Examples include:
- Climate – Those who live in a dry or cold climate are more prone to develop this condition.
- Season – There is an increased risk of developing eosinophilic esophagitis between the spring and fall. However, physicians think is linked with increased levels of pollen and other allergens during this period.
- Sex – This condition happens more frequently in men than women.
- Family history – Some healthcare providers think that this condition has a genetic component that runs in families. In other words, people with this abnormal gene are more likely to develop this condition.
- Allergies and asthma – People with environmental or food allergies, asthma, atopic dermatitis, or chronic respiratory disease are at increased risk of developing eosinophilic esophagitis.
- Age – Previously, was thought that this condition happens in children only but nowadays it is known that eosinophilic esophagitis is common among adults too. However, the symptoms appear differently in children and adults.
What Are The Possible Complications of Eosinophilic Esophagitis?
In some cases, this condition may cause certain complications, especially without treatment. For example:
- Esophagus damage – People with this condition may experience damage to the esophagus due to inflammation.
- Narrowing and scarring of the tube that carries food from the mouth to the stomach (esophagus) – This complication makes it difficult to swallow and increases the risk of getting food stuck in the esophagus.
- Esophageal perforation
- Malnutrition
- Ulcers in the esophagus
Diagnosis
First, doctors will ask some questions about your medical history and symptoms then may perform some tests to confirm the condition and rule out that cause similar symptoms. For example:
- Upper endoscopy – This test involves a long and narrow tube (endoscope) with a camera on the end that is inserted through the mouth down the esophagus. It helps determine whether you have inflammation, swelling, vertical furrows, horizontal rings, and other abnormalities.
- Biopsy – During the previous test, physicians may remove a small sample of the esophagus and send it to the laboratory for testing. It helps determine the amount of eosinophils.
- Blood tests – These tests are usually performed when doctors suspect eosinophilic esophagitis. They help determine the source of allergy (allergens), total immunoglobulin E levels, and others.
- Esophageal sponge – This test involves swallowing a capsule that is attached to a string. When the capsule is dissolved in the stomach it releases a sponge that your doctor will pull out of the mouth with the string. It helps determine the inflammation degree even without endoscopy.
Treatment
This is a chronic relapsing condition, which means some people will need long-term treatment to control the symptoms. Check below some treatment options often recommended by doctors for people with this health condition:
Dietary Therapy
Healthcare providers may recommend to stop eating certain foods (such as dairy or wheat products) that cause allergic reactions. It may help lessen the symptoms and inflammation. In some cases, people need to limit their diet even more.
Medicines
- Proton pump inhibitor (PPI) – This medicine is used to reduce the symptoms and prevent them from worsening.
- Topical steroids – People who do not respond to the previous medicines, may need a prescription steroid (such as Budesonide or Fluticasone) to treat this condition. It usually comes in a liquid form that is swallowed.
- Monoclonal antibodies – The FDA has approved a medicine (Dupilumab) for adults and children over 12 years old for treatment. This medicine works by blocking the action of proteins that cause inflammation.
Dilation
People who experience severe narrowing (also known as a stricture) of the esophagus may need dilation. This is a procedure that may help swallow easier. However, this treatment option may be used if you do not take steroids or instead of medicines.
Frequently Asked Questions
What is the primary cause of eosinophilic esophagitis?
This condition often occurs due to an allergic reaction to food or the environment. However, it may occur due to other causes. Discuss with your physician for more details.
Can eosinophilic esophagitis be cured?
Unfortunately, there is no way to cure this condition. Therefore, people with this condition usually require long-term treatment. The most common treatment options include medicines, dietary changes, and dilation.
What are foods that often trigger eosinophilic esophagitis?
These include:
- Milk and dairy
- Wheat
- Egg
- Soy
- Peanuts and tree nuts
- Fish and shellfish
However, this article does not contain all possible foods that trigger the condition. If you have additional questions, ask your physician.
