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All About EOE


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Eosinophilic Esophagitis

AKA:  EOE, EE

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WHAT IS IT?

Eosinophilic Esophagitis- Is an allergic reaction that causes swelling (inflammation) in the esophagus.  The esophagus is the tube that goes from your mouth to the stomach. The swelling can make the esophagus become more narrow and stiff.  This can make swallowing difficult and food can get stuck in the esophagus.

EOE is becoming more commonly diagnosed in both children and adults.  This is a chronic condition and does not go away completely.

WHAT CAUSES IT?

People that have EOE have more eosinophils (a particular white blood cell) in their esophagus.  The cause of this isn’t exactly known. Most of the research suggests that it’s because of an allergic reaction to certain types of proteins found in food. Many people with EOE have a family history of allergic reactions such as asthma, runny nose, and skin rash or food allergies.

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WHAT ARE THE SYMPTOMS?

The most common symptoms of EOE is difficulty swallowing and pain when swallowing solid foods.  Other symptoms include:

  • Vomiting (often during or after meals)
  • Heartburn
  • Stomach pain
  • Chest pain
  • Nausea
  • Weight loss

HOW IS IT DIAGNOSED?

The only way to know for sure if your symptoms are causes by EOE is to have an endoscopy.  During an endoscopy the doctor inserts a thin, flexible tube with a light into the esophagus.  This allows that doctor to see inside your esophagus and take tissue samples (biopsies). The tissue samples are then sent to a lab and can be tested for eosinophils and other signs of EOE.

HOW IS IT TREATED?

EOE treatment is mostly focused on controlling symptoms and preventing other problems.  The symptoms can be controlled but may return every so often. Your doctor may recommend one or more of these treatments:

Stretching the esophagus. If the treatments below don’t work well enough, the doctor may recommend inserting a balloon-like device to gently dilate (stretch) the esophagus.  This can allow food to pass through easily.

Diet Changes.  Your doctor may recommend that you stop eating certain foods for a period of time.  In some cases, this may mean stopping several foods and then bringing one of them back at a time into your diet.  This is also called the ELIMINATION DIET. This will help you know if that food is causing a problem. Foods to stop eating may include milk, egg, wheat, soy, tree nuts or shellfish.

Medicine.  The doctor may recommend medicine to lower stomach acid and inflammation.  The doctor might do this to see if the symptoms are caused by another illness like GERD (gastroesophageal reflux disease).  Other medications might be recommended such as swallowed steroids that help coat the esophagus to help get rid of the eosinophils.

Visit an allergy doctor:  An allergist can help identify which foods you should stop eating.  They do this by doing blood tests, Skin Scratch tests, Patch testing or the elimination diet can be helpful.

WHAT CAN HAPPEN IF IT ISN’T TREATED?

If EOE is not treated or your symptoms are not controlled well.  This may cause other health problems. These include narrowed areas in your esophagus where food can get stuck. This may cause forceful vomiting. Repeated dilations may cause a tear of the esophagus, which would need medical attention immediately.

GET EMERGENCY CARE IF YOU HAVE:

  • Chest pain that lasts more than a few minutes.
  • Food that is stuck in your esophagus that you can’t get out.

Sources:  Intermountain Healthcare- this content does not substitute for professional medical advice and it should not be used to diagnose and treat

 

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