Eosinophilic Esophagitis (EoE) is a chronic allergic/immunological condition of the esophagus, characterized by high levels of eosinophils (a type of white blood cell) in the esophageal tissue. This accumulation of eosinophils causes inflammation and damage to the esophagus, leading to symptoms such as dysphagia (difficulty swallowing), odynophagia (painful swallowing), and a sensation of burning. The prevalence of eosinophilic esophagitis has been estimated to range between 43-52/100,000 population.
Risk Factors:
Individuals with atopic dermatitis, asthma, or food allergies (e.g., dairy, soy, wheat, eggs, nuts, fish, and shellfish) and environmental allergies (e.g., pollen, dust mites) are at a significantly higher risk of developing eosinophilic esophagitis.
Symptoms:
Adults may experience odynophagia (pain when swallowing) with solids, food impaction in the esophagus, heartburn, vomiting or nausea, chest and/or abdominal pain, weight loss, or esophageal rupture.
Diagnosis:
An important part of diagnosing the disease, alongside the history and clinical examination, is endoscopy with biopsy. Differential diagnosis from gastroesophageal reflux disease (GERD) and Crohn’s Disease is also essential.
Treatment:
Dietary Changes
A diet that excludes the six most allergenic foods, such as soy, shellfish, nuts, wheat, eggs, and dairy, should be followed. Alternatively, foods causing allergies can be avoided after confirmation through allergy tests.
Pharmacological Treatment
Corticosteroids (topical or systemic) for 6 weeks.
Proton Pump Inhibitors (PPIs). A portion of patients with eosinophilic esophagitis may respond to PPI therapy for 8 weeks. Management of eosinophilic esophagitis requires collaboration between a gastroenterologist, allergist, and nutritionist for the best possible treatment and improvement in the patient’s quality of life.
