Eosinophilic Esophagitis

 Eosinophilic (e-o-sin-o-FILL-ik) esophagitis (EoE) is a recognized chronic allergic/immune condition of the esophagus. The esophagus is the tube that sends food from the mouth to the stomach. In EoE, large numbers of white blood cells called eosinophils are found in the inner lining of the esophagus. Eosinophils can release substances into surrounding tissues that cause inflammation. Normally there are no eosinophils in the esophagus. A person with EoE will have inflammation and increased numbers of eosinophils in the esophagus. The chronic inflammation of EoE leads to symptoms.

The symptoms of EoE vary with age. Infants and toddlers may refuse to eat or not grow properly. School-age children often have decreased appetite, recurring abdominal pain, and trouble swallowing or vomiting. Teenagers and adults can have the same symptoms, but often have difficulty swallowing dry or dense, solid foods. The difficulty swallowing occurs because the esophagus is inflamed, and in severe cases, because the esophagus narrows to the point that food gets stuck. Food firmly stuck in the esophagus is called a “food impaction,” which can be a medical emergency if the food does not go down the esophagus into the stomach or is not vomited up relatively quickly.

Allergists and gastroenterologists are seeing many more patients with EoE. This is due to an increased incidence of EoE and greater physician awareness. EoE is considered to be a chronic condition that can be medically managed, but is not outgrown.

Eosinophils can be found in the esophageal tissue in diseases other than EoE. One common example is acid reflux disease. Other diseases that can cause eosinophils to be in the esophagus must be ruled out before EoE can be accurately diagnosed.

From AAAAI