Eosinophilic Esophagitis

Eosinophilic esophagitis, or EoE, is a chronic immune system disease that can make eating difficult and even painful. At North Shore Gastroenterology, our team is dedicated to helping patients identify their triggers, manage inflammation, and eat comfortably again.

A close-up view of the esophagus during an upper endoscopy, showing characteristic rings and white spots indicative of Eosinophilic Esophagitis

What is Eosinophilic Esophagitis?

Eosinophilic esophagitis, or EoE, is an allergic reaction that takes place in the esophagus. It occurs when a type of white blood cell called an eosinophil builds up in the lining of the esophagus.

Eosinophils are typically present in the digestive tract but not in the esophagus. When they accumulate there, they cause inflammation and damage to the esophageal tissue.

Over time, this chronic inflammation can lead to narrowing of the esophagus (strictures) and difficulty swallowing. EoE is often considered a "food allergy" of the esophagus, as it is frequently triggered by a reaction to foods, allergens, or acid reflux.

Causes and Risk Factors

The exact cause of eosinophilic esophagitis is complex, involving a mix of genetics and environmental factors. It is generally believed to be an immune response to specific foods or environmental allergens like pollen.

Several factors may increase your risk of developing EoE:

  • Allergies: A significant majority of patients with EoE have other allergic conditions, such as food allergies, asthma, eczema, or hay fever.
  • Family History: Genetics play a role, and having a family member with EoE increases your risk.
  • Climate: Studies suggest living in a cold or dry climate may be a risk factor.
  • Season: Diagnoses often increase during spring and summer, correlating with high pollen counts.

Symptoms of Eosinophilic Esophagitis

Symptoms of EoE can vary significantly depending on age. In adults, the most common complaint is difficulty swallowing solid food.

Common symptoms include:

  • Dysphagia: Difficulty swallowing, often described as food getting stuck in the chest.
  • Food Impaction: Food becoming firmly lodged in the esophagus, requiring emergency medical removal.
  • Chest Pain: Central chest pain that does not respond to antacids, often occurring during or after eating.
  • Regurgitation: Backflow of undigested food.
  • Heartburn: Persistent heartburn that doesn't improve with standard reflux medication.

Diagnosing Eosinophilic Esophagitis

Because EoE shares symptoms with gastroesophageal reflux disease (GERD), accurate diagnosis is essential.

Diagnostic procedures typically include:

A thin, flexible tube with a camera is passed down the throat to visually examine the esophagus. Signs of EoE may include white spots, rings, or narrowing.

During the endoscopy, the doctor will take small tissue samples from the lining of the esophagus. These samples are examined under a microscope by a pathologist to count the number of eosinophils. A high count confirms the diagnosis.

While not diagnostic on their own, blood tests may be used to look for elevated eosinophil counts or specific allergen sensitivities.

Treatment and Management Options

There is currently no cure for eosinophilic esophagitis, but it can be effectively managed. The goals of treatment are to reduce inflammation, relieve symptoms, and prevent complications like strictures.

Treatment strategies at North Shore Gastroenterology include:

Removing common trigger foods (such as dairy, wheat, egg, soy, nuts, and seafood) and gradually reintroducing them to identify the culprit.

A liquid diet of amino acid-based formulas is used in severe cases to allow the esophagus to heal.

Medications like swallowed topical steroids, proton pump inhibitors (PPIs), and newer biologic therapies are often prescribed to reduce inflammation and manage symptoms effectively.

If the esophagus has become narrowed due to scar tissue, a procedure to gently stretch the esophagus may be performed during an endoscopy to improve swallowing.

Eosinophilic Esophagitis Care in Westlake or Brooklyn, OH

Living with eosinophilic esophagitis requires ongoing management and a supportive medical team. North Shore Gastroenterology is here to help you navigate dietary changes and treatment options with confidence.

Contact us today at (440) 808-1212 or request an appointment online to schedule a visit.