Eosinophilic esophagitis, or EoE, is a condition where the esophagus (the tube you swallow food through) becomes inflamed due to an allergic response. This happens when too many immune cells called "eosinophils" gather in the esophagus, causing swelling and stiffness. This can lead to problems like trouble swallowing, food getting stuck, chest pain, heartburn, and even rare issues like tears in the esophagus.
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People with EoE might experience:
- Difficulty swallowing
- Pain with swallowing
- Feeling like food is stuck in the chest
- Nausea
- Vomiting
- Chest pain
- Heartburn
- Abdominal pain
- Weight loss
To diagnose EoE, biopsies (samples of tissue) from the esophagus are taken during a procedure called upper endoscopy. This tissue is looked at under a microscope to count the eosinophils. If there are more than 15 of these cells in the microscopic view, it is usually a sign of EoE.
There are different ways to treat EoE to prevent complications such as esophageal narrowing or strictures:
Diet
Some people's EoE is triggered by specific foods. Under the guidance of a GI dietitian, you might follow an elimination diet. This means you stop eating certain foods, like milk, wheat, eggs, soy, peanuts, or fish, for around 6-8 weeks. Then, your doctor will compare biopsy results before and after to see if the inflammation has improved.
Medications
Proton Pump Inhibitors (PPIs): These are medicines that reduce stomach acid production. They are often the first choice if acid reflux is a symptom of your EoE. PPIs can also have anti-inflammatory effects.
Topical Corticosteroids: If your EoE doesn't respond to diet or PPIs, you might use steroid medications through an asthma inhaler. Instead of inhaling them, you swallow the medicine. It helps directly reduce inflammation in the esophagus.
Emerging Medications: Scientists have developed new medications that target the specific pathways causing EoE. One example is dupilimab (Dupixent), originally for asthma treatment.
Endoscopic Dilation
If EoE leads to narrowing of the esophagus, making it hard for food to pass, a procedure called endoscopic dilation can help. This involves using inflatable balloons to gently stretch the narrowed area. It's usually safe and effective.
Remember, treatment options can vary based on your specific situation. Consulting with a gastroenterologist will help determine the best approach for managing your EoE.