Eosinophilic Esophagitis

Eosinophilic Esophagitis is an allergic inflammatory condition of the esophagus which causes excess eosinophils- also known as white blood cells. It can be caused by frequent acid reflux, allergies, radiation, medications that can get stuck in the esophagus, bacteria, fungi, and viruses such as candida and the herpes simplex virus. In most people, the cause of their Eosinophilic Esophagitis is an allergic reaction due to the fact that white blood cells play a large role in the inflammation caused by allergens. Doctors and researchers do not yet know how the allergic reaction in the esophagus occurs- whether it is by an inhaled substance or an ingested substance that the patient possesses an allergy to. The symptoms of this condition in adults include heartburn, dysphagia (trouble swallowing often due to narrowing of the esophagus), chest pain, and nausea. Vomiting, abdominal pain, and failure to thrive are the most commonly seen symptoms in adolescent patients. Although Eosinophilic Esophagitis is a newly recognized condition, it is extremely vital that doctors diagnose and treat it due to the fact that it can result in scarring, impaired functioning of the esophagus, esophageal cancer, and a great deal of pain.

Once symptoms are displayed, testing must be done to confirm the presence of excess eosinophils. The only way to check for Eosinophilic Esophagitis involves an endoscopy procedure. To perform this procedure the patient is placed under anesthesia and a flexible, lighted endoscope with a camera is inserted through the mouth of the patient. The tube then travels down the esophagus, into the stomach, and into the first part of the small intestine- the duodenum. Tissue samples are then taken from the lining of the esophagus and are sent to a lab to examine for the presence of excess eosinophils. If the results come back positive, allergy skin testing is commonly the next step to take. Eliminating foods and other things that the patient is allergic to is highly important. Once the cause is established, treatment must begin to avoid permanent damage. Short term use of oral or inhaled steroids has proven to be extremely effective. For Eosinophilic Esophagitis caused by fungi, viruses, or bacteria, medication is prescribed to clear up the issue. Proton pump inhibitors are also utilized in preventing esophageal scarring by controlling excess stomach acid production. Additional monitoring including repeat endoscopies is also necessary to make sure that the condition does not return. With a combination of avoiding triggers such as allergens, taking medication, and living a healthy lifestyle, Eosinophilic Esophagitis can be quite manageable.