Eosinophilic Esophagitis (EoE)

Eosinophilic esophagitis (EoE) is a disease that affects your esophagus (the tube that carries food and drinks from your mouth to your stomach).

In people with EoE, certain white blood cells called eosinophils build up in the esophagus. This can make the esophagus swollen and stiff, which makes it hard to swallow food.

EoE affects about 1%-2% of the population.

Cause

Doctors aren’t exactly sure what causes EoE. It could be triggered by an allergic reaction or hypersensitivity to certain foods or allergens.

Risk Factors

You may be more likely to get it if you have:

• a history of non-food allergies or asthma
• a family member with it
• acid reflux (acid and bile from the stomach flowing back into the esophagus)
• GERD (ongoing and more severe acid reflux called gastroesophageal reflux disease)

Symptoms

Symptoms of EoE include:

• Trouble swallowing food or drinks
• Food getting stuck in your throat
• Chest pain
• Heartburn (a burning feeling in your chest)
• Vomiting

When to See a Healthcare Provider

Talk to your doctor if you have any of the symptoms.

Prevention

Since doctors don’t know exactly what causes EoE, it’s hard to prevent. But avoiding foods or things you’re allergic to might help. Having a healthy diet may also help.

Diagnosis

Doctors check for EoE by doing an upper endoscopy (looking inside your esophagus with a small camera). During the procedure, the doctor will take biopsies (removing small pieces of tissue to test) from different parts of the esophagus. The diagnosis is confirmed by a pathologist seeing a lot of eosinophils in the lining of the esophagus when they look at the biopsy specimens under the microscope.

Treatment & Management

Treatment usually starts with medicine to reduce acid in the stomach (called proton pump inhibitors or PPIs). This is done to reduce acid reflux and to improve the inflammation (swelling, pain, redness).

If that doesn’t help, doctors might suggest:

• Swallowed steroid medications
• A Six Food Elimination Diet that removes common allergy-causing foods from your diet, then adds them back in one at a time to help identify the food trigger
• An injectable medication known as dupixent

Gently stretching open your esophagus (dilatation) during an endoscopy may be suggested if you are still having trouble swallowing and if your esophagus is narrow.

Long-Term Prognosis

There is no cure for EoE but with the right treatment and ongoing check-ups, most people with EoE can feel better and avoid serious problems.