Signs and Symptoms of Eosinophilic Esophagitis (EoE)
- Difficulty swallowing (dysphagia)
- Food impaction (food gets stuck in the esophagus)
- Throat pain
- Reflux symptoms, such as burping, bad taste in the mouth, regurgitation, or burning, that don’t improve with medicines
Older children may experience:
- Abdominal pain
- Trouble swallowing
- Food impaction
- Poor appetite
- Reflux that doesn’t improve with medicines
- Poor appetite or growth
- Feeding problems
- Reflux that doesn’t improve with medicines
Causes and Risk Factors of Eosinophilic Esophagitis (EoE)
- Have family members with the condition
- Are male
- Have other allergic diseases, such as eczema, hay fever, asthma, or food allergies
- Are exposed to seasonal allergens
How Is Eosinophilic Esophagitis (EoE) Diagnosed?
- Physical exam?During this process, your provider might ask you about your symptoms and family history.
- Endoscopy?A long, flexible tube with a light and camera on the end is placed down your esophagus. Your doctor will look for signs of EoE, which may include narrowing, inflammation, white spots, or rings.
- Biopsy?While performing an endoscopy, your doctor takes small tissue samples from your esophagus. The samples are examined for eosinophils. A biopsy is the only way to confirm a diagnosis of EoE.
- Other tests?Sometimes blood tests, food allergy testing, or other exams may be given.
Prognosis of Eosinophilic Esophagitis (EoE)
Researchers are still learning about the prognosis and long-term effects of EoE.
Duration of Eosinophilic Esophagitis (EoE)
Treatment and Medication Options for Eosinophilic Esophagitis
Therapy often starts with some medications approved for other conditions that
may help symptoms of EoE. These include:
- Proton pump inhibitors (PPIs)?These drugs lessen acid production in the stomach and may reduce inflammation in the esophagus. But not all patients with EoE respond to PPIs.
- Topical steroids They can help control inflammation in the esophagus. You swallow the liquid steroid. The type of steroids doctors typically prescribe for EoE isn’t absorbed in the bloodstream, so you probably won’t experience side effects normally associated with steroids.
Dietary Therapies and Food Strategies
- Peanuts and tree nuts
- Fish and shellfish
- Elimination diet?For this plan, you eliminate certain foods or beverages for several weeks and add them one at a time to see which may be problematic. You might have an allergy test first to determine which foods to avoid.
- Elemental diet?With this approach, you stop eating and drinking all proteins and consume an amino acid formula instead. If your symptoms go away, you might be able to add foods back one at a time to see if you can tolerate them. If you have difficulty drinking the formula or you’re not getting adequate nutrition, your doctor may place you on a feeding tube. Because this is such a difficult diet to follow, it’s rarely done.
- Tomato sauce
- Fried or fatty foods
Alternative and Complementary Therapies
Symptoms may crop up unexpectedly in social situations or at inopportune times, which could lead to embarrassment.
Adopting a healthy lifestyle and keeping stress levels at bay may help you manage your symptoms and feel better overall.
Prevention of Eosinophilic Esophagitis (EoE)
There’s no way to prevent EoE from developing, but there are effective strategies to manage your symptoms.
Complications of Eosinophilic Esophagitis
In some cases, EoE can lead to complications, such as:
- Damage to the esophagus?Inflammation of the esophagus makes tearing or perforation more likely. This damage can occur when you get food stuck in your esophagus or as the result of an endoscopy.
- Narrowing or scarring of the esophagus?When your esophagus narrows, it makes swallowing more difficult and puts you at risk of food impaction.Your doctor can stretch the narrowing with a procedure called dilation (mentioned above in the section on treatments), which can be done during an upper endoscopy.
Research and Statistics: How Many People Have Eosinophilic Esophagitis?
- Fewer childhood infections might lead to more allergic diseases.
- The typical Western diet could alter the population’s microbiome.
- Environmental factors, such as chemical additives, genetic crop modifications, pollutants, or food processing may be contributors.
- Fewer Helicobacter pylori (H. pylori)?infections (a common cause of peptic ulcers) may mean less protection against some allergic diseases.
- More cases of GERD could correlate with more instances of EoE. The idea is acid reflux might break the barrier of the esophagus and allow food allergens to stimulate the immune system.
- Increased use of acid-suppressing drugs, especially early in life, might change the microbes in the esophagus or raise a person’s risk of developing a food allergy.
Related Conditions and Causes of Eosinophilic Esophagitis
Certain disorders may look like EoE or occur along with it.
Some conditions closely related to EoE include:
If you or your child has EoE, you’re not alone. Many resources provide support and helpful information.
Favorite?Orgs?for Essential EoE Info
APFED is a nonprofit that was started in 2001 by a group of mothers whose children had EoE. This organization is dedicated to improving the lives of patients and families living with EoE. They provide an array of education, awareness, advocacy, and support opportunities.
CURED is committed to raising funds and increasing awareness for EoE and other eosinophilic gastrointestinal diseases. To date, the organization has donated more than $5.5 million to research.
The EOS Network’s mission is to ensure that every person with an eosinophilic gastrointestinal disease receives a prompt, accurate diagnosis; the right treatment for them; and support to live with their condition. We especially love their recipes and cooking tips section for ideas on how to keep mealtimes interesting, even if you’re cutting out certain foods.
Favorite Professional Organizations for EoE
The AAAAI is a professional membership organization that includes more than 7,000 allergists and immunologists. On their site, you can take a quiz to see how much you know about EoE. We also like their Find an Allergist page, which helps you locate a qualified allergist or immunologist in your area.
This professional organization promotes excellence in patient care. They provide credible information about EoE. We like their Ask the Allergist section, which gives answers to common questions asked by the public.
The ACG is comprised of a group of professionals that promote prevention, diagnosis, and treatment of digestive disorders. Their site provides in-depth information about various digestive health topics, including EoE.
The IES is a group of scientists and clinicians who have an interest in eosinophil diseases. The organization was established to bring together scientists from around the world who are involved in eosinophil biology and eosinophil disorders research.
Favorite Online Support Networks
APFED’s online support community, EOS Connections, provides a platform for patients, caregivers, and family members to connect with others and share information. Additionally, you can find a list of local eosinophilic support groups on APFED’s page.
Favorite Resource for Diet Advice
This handout, created by UW Integrative Health, provides a wealth of information about the elimination diet. We like the printable food diary chart for logging food and beverage consumption.
FARE works to improve quality of life for people with food allergies. Their site offers educational tools and research, including information about the elimination diet and U.S. laws and regulations regarding food allergies.
Favorite Blog for EoE
This blog, written by a patient who has lived with EoE for 35 years, provides both personal accounts and educational information.
Favorite Patient-Centered Medical Conference
APFED’s EOS Connection Patient Education Conference is an annual event where attendees can network with patients, families, and other community members, and learn about new resources and research.
Editorial Sources and Fact-Checking
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- Eosinophilic Esophagitis.?MedlinePlus. May 17, 2021.
- Eosinophilic Esophagitis.?American Academy of Allergy, Asthma & Immunology. February 24, 2020.
- Eosinophilic Esophagitis (EoE).?Asthma and Allergy Foundation of America. May 2021.
- EoE.?American Partnership for Eosinophilic Disorders.
- Eosinophilic Esophagitis.?American Academy of Family Physicians. September 17, 2020.
- Eosinophilic Esophagitis.?National Organization for Rare Disorders. 2019.
- Eosinophilic Esophagitis.?American College of Gastroenterology. July 2019.
- Carr S, Chan ES, Watson W. Eosinophilic Esophagitis.?Allergy, Asthma & Clinical Immunology.?September 12, 2018.
- FDA Approves First Treatment for Eosinophilic Esophagitis, a Chronic Immune Disorder.?U.S. Food and Drug Administration. May 20, 2022.
- Eosinophilic Esophagitis.?Johns Hopkins Medicine.
- Taft TH, Guadagnoli L, Edlynn E. Anxiety and Depression in Eosinophilic Esophagitis: A Scoping Review and Recommendations for Future Research.?Journal of Asthma and Allergy. December 2019.
- Stress: 10 Ways to Ease Stress. Cleveland Clinic. October 2020.
- Eke R, Dellon E. Hospitalization Trends and Determinants of Inpatient Costs for Eosinophilic Esophagitis Patients in the United States: Results from the Nationwide Inpatient Sample Analysis. Annals of Gastroenterology. June 2021.
- Eosinophilic Esophagitis. American College of Allergy, Asthma & Immunology. May 2022.
- Garber J. Eosinophilic Esophagitis: A New Food-Related Allergic Condition on the Rise??Harvard Health Publishing.?December 26, 2019.
- Akhondi, H. Diagnostic Approaches and Treatment of Eosinophilic Esophagitis: A Review. Annals of Medicine and Surgery. June 2017.