Eosinophilic Esophagitis

Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus that affects both children and adults. It is characterized by the presence of high numbers of eosinophils, a type of white blood cell, in the esophageal mucosa.

Causes and Risk Factors

The exact cause of EoE is not fully understood, but it is believed to be related to an allergic reaction or immune system dysfunction. Common triggers include:

• Foods: Milk, eggs, wheat, soy, nuts, and fish are common food allergens that can trigger EoE.
• Environmental allergens: Pollen, dust mites, and pet dander may also contribute to the development of EoE.
• Genetic predisposition: Individuals with a family history of EoE or other atopic diseases, such as asthma or eczema, are more likely to develop the condition.

Symptoms

The symptoms of EoE can vary depending on the age of the individual and the severity of the disease. Common symptoms include:

• Dysphagia (difficulty swallowing)
• Food impaction (food getting stuck in the esophagus)
• Chest pain or discomfort
• Nausea and vomiting
• Abdominal pain
• Weight loss or failure to thrive in children

Diagnosis

The diagnosis of EoE is typically made through a combination of:

• Endoscopy: A flexible tube with a camera and biopsy forceps is used to visualize the esophagus and collect tissue samples.
• Biopsy: The presence of eosinophils in the esophageal mucosa is confirmed through histological examination of the biopsy samples.
• Medical history and physical examination: A thorough medical history and physical examination are essential to rule out other conditions that may cause similar symptoms.

Treatment

The treatment of EoE typically involves a combination of:

• Dietary modifications: Avoidance of trigger foods or implementation of an elemental diet (a diet consisting of amino acids, sugars, and fats) may help alleviate symptoms.
• Medications: Corticosteroids, such as fluticasone or budesonide, may be prescribed to reduce inflammation in the esophagus.
• Esophageal dilation: In some cases, esophageal dilation may be necessary to relieve narrowing of the esophagus caused by chronic inflammation.

Complications

If left untreated or undertreated, EoE can lead to several complications, including:

• Esophageal stricture (narrowing of the esophagus)
• Esophageal rupture
• Bleeding or perforation of the esophagus
• Nutritional deficiencies and weight loss

Prognosis

The prognosis for individuals with EoE is generally good, especially if treatment is initiated early in the course of the disease. With proper management, most individuals can experience significant improvement in symptoms and quality of life.