Eosinophilic Esophagitis (EoE)

What is Eosinophilic Esophagitis?

Eosinophilic esophagitis, which is also referred to as EoE, is a chronic allergic/immune system disease caused by a reaction to acid reflux, allergens, or food. It is characterized by swelling or inflammation within the esophagus.

This condition is caused by the collection of white blood cells, known as eosinophils, in esophageal issue, where you normally don’t find any eosinophils.

When eosinophils build up in the esophagus, they cause injury or inflammation, and they damage the tissue as a result.

EoE occurs most often in Caucasian males, and it can develop at any age.

What are the Symptoms of Eosinophilic Esophagitis?

Symptoms of eosinophilic esophagitis will depend upon the age of the patient. For example, if it develops in an infant or a toddler, they might refuse food and fail to grow properly. Children might suffer from abdominal pain, vomiting, or trouble swallowing.

Teens and adults, on the other hand, will likely have trouble swallowing. The esophagus could narrow so much that food will get stuck in the throat, causing food impaction, which is an emergency.

Eosinophilic Esophagitis Causes

The exact cause behind eosinophilic esophagitis is not yet known. The current theory about this condition is that it’s caused by specific food creating an immune system response. The white blood cells of the lining of the esophagus begin to multiply, causing it to become inflamed. Most people who suffer from eosinophilic esophagitis also have environmental or food allergies. In addition, there are several genes that are known to be related to EoE. One of these is calpain14 (CAPN14) and is related to the esophagus. Another related gene is eotaxin-3, related to the control of the accumulation of white blood cells. Other genes that are believed to contribute to this condition are TSLP (at chromosome 5q22) and CAPN14 (at chromosome 2p23).

Many who have this condition also have other diseases caused by allergies, including eczema, asthma, atopic dermatitis, chronic respiratory disease and rhinitis, further supporting the correlation to an immune response. There may also be a genetic link, as some families have more than one person with this condition. Like asthma and allergies, this condition is growing in numbers, possibly due to an increase in pollutants in the air.

How is Eosinophilic Esophagitis Treated?

The majority of patients with EoE will need ongoing treatment in order to control symptoms. Since glucocorticostroids can reduce inflammation it can be helpful. However, there currently aren’t any medicines available that have been approved to treat eosinophilic esophagitis, but some medications can reduce the amount of eosinophils within a patient’s esophagus, thereby reducing symptoms.

Treatment includes

  • Dietary changes after testing for food allergies
  • Acid blockers, such as a proton-pump inhibitor (PPI)
  • Steroid prescriptions, such as budesonide or fluticasone
  • Dilation of the esophagus

Eosinophilic Esophagitis Prevention

Because the exact cause of this condition isn’t known, it may not be possible to prevent every case of EoE. However, because it is theorized to be similar to an allergy, it may be helpful to have allergy testing done. Allergy testing can help you to identify the environmental items as well as the foods that you’re allergic to. This can help you to know what to avoid in order to prevent many of the immune responses that can cause EoE. Improve the quality of your indoor air by opening windows when possible and not allowing toxic fumes in the home. Avoid burning candles or incense indoors, and use fragrance-free products.

Resources
Last Reviewed:
September 20, 2016
Last Updated:
December 19, 2017