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9 Surprising Facts About Eosinophilic Esophagitis
Medically Reviewed By William C. Lloyd III, MD, FACS
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EoE is a major cause of digestive problems.p>If you’re like most people, you don’t know much about eosinophilic esophagitis (EoE), a chronic disease of the esophagus, or tube-like structure leading from the mouth down to the stomach. Normally, food moves through this tube without any problems. In some people, though, eosinophils, a special kind of white blood cells, build up in the esophagus and cause inflammation, making eating difficult and uncomfortable. These 9 surprising eosinophilic esophagitis facts will help you understand what causes EoE, how doctors approach treatment, what’s involved in an eosinophilic esophagitis elimination diet, and whether EoE is linked to cancer. -
1. Eosinophilic esophagitis is a relatively new diagnosis.One reason you don’t know much about EoE: This disease was identified over the past two decades. Now, doctors are realizing that at least some people who think they have acid reflux may actually have eosinophilic esophagitis. Both adults and children can develop EoE. About 1 in 1500 children has EoE, according to the Children’s Hospital of Philadelphia. The American Partnership for Eosinophilic Disorder estimates approximately 1 in 2000 people is affected.
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2. EoE is triggered by an immune reaction to food.No one knows exactly what causes EoE, but physicians know that the buildup of eosinophils in the esophagus is caused by an immune reaction to specific foods. They also know that the foods that trigger EoE vary from individual to individual. In some ways, EoE is similar to a food allergy; in fact, the disease is most common in people who have allergies. But while most allergic reactions appear soon after ingesting an allergen, the immune reaction that causes EoE seems to develop over days.
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3. Eosinophilic esophagitis may run in families.People who have a family member with EoE are more likely to develop the disease. That holds true even if the family member is a distant relative who grew up in a completely different environment, suggesting that genetics, rather than a shared environment or similar lifestyle, is likely the causative factor. Researchers have already identified a number of genes that play a role in EoE, including a gene called calpain14 (CAPN14).
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4. Males are more likely than females to develop eosinophilic esophagitis.Males are approximately three times more likely to develop EoE than females. To date, no one knows why males are more likely to be affected. Other factors that increase an individual’s risk of EoE include a personal or family history of allergies, eczema, hay fever or asthma, and residence in a cold or dry climate. EoE can affect people of all ethnic backgrounds, but individuals of Caucasian descent are more likely to have eosinophilic esophagitis.
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5. Symptoms include reflux and failure to thrive.EoE can occur in infants, toddlers, children, teenagers and adults. In infants, the most common symptoms include feeding problems (such as refusing the breast or bottle or fussing during and after feedings), frequent regurgitation, poor weight gain, and reflux that doesn’t get better with medication. Older children may exhibit aversions to food, reluctance to eat, and trouble sleeping. Teenagers and adults may report heartburn, chest or abdominal pain, and difficulty swallowing. If you or your child exhibit any of these symptoms, seek a medical evaluation.
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6. A biopsy is necessary for an EoE diagnosis.Whenever an individual has difficulty eating or thriving, physicians conduct a physical exam and collect information about the patient’s personal and family medical history. If a problem is suspected, the physician may order an upper endoscopy. During the endoscopy, the physician will likely obtain a few tissue samples from your esophagus. (Don’t worry, you’ll receive numbing medication before the procedure; children receive full anesthesia.) The samples, or biopsies, will be sent to a lab for analysis. If eosinophils are present in the sample, you have EoE.
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7. Medical treatment focuses on symptom control.Right now, there is no cure for eosinophilic esophagitis. However, doctors have found that a combination of diet and medication can effectively control symptoms in most patients. Medications commonly prescribed to treat EoE include steroids, either in inhaler, liquid or pill form. Topical steroid medication (delivered via inhaler or a swallowed liquid) can control inflammation and may put EoE into remission. Steroid pills aren’t usually used long-term to treat EoE but can be used during bad bouts. Acid-suppressing medications, including omeprazole and lansoprazole, can decrease reflux and increase comfort.
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8. An elimination diet can help identify trigger foods.Avoiding trigger foods is an effective way to manage eosinophilic esophagitis, but first you have to identify the trigger foods. An eosinophilic esophagitis elimination diet allows you to do just that. There are a couple different approaches to an EoE elimination diet. Some doctors recommend allergy testing first; then, the affected individual stops eating any foods identified as allergens to see if symptoms improve. Others recommend eliminating common allergy triggers, such as dairy, wheat, eggs, soy, peanuts, tree nuts and fish/shellfish to begin, and then adding back foods gradually, over time, to see which ones trigger symptoms.
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9. Eosinophilic esophagitis doesn’t seem to increase the risk of cancer.There has been some concern EoE may increase an individual’s risk of developing esophageal cancer. But as of now, “There is currently no strong data suggesting EoE causes cancer of the esophagus,” according to American Partnership for Eosinophilic Disorders. However, EoE is still a relatively new diagnosis. Because the disease was first identified a generation ago, scientists don’t yet have a good understanding of the natural history of this disease. Researchers are carefully tracking children and adults with EoE to learn more.
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9 Surprising Eosinophilic Esophagitis Facts
