Eosinophilic esophagitis inflammation that happens in the esophagus, i.e. the "food
pipe." The esophagus becomes inflamed and does not contract properly. It can get narrowed
and develop rings or abscesses. The symptoms happen when your immune system makes
white blood cells in reaction to an allergen. The white blood cells are called eosinophils.
The condition is called eosinophilic esophagitis, or EE or EoE. It can happen at any
age and is commonly seen in white males.
EoE is often caused by an allergic reaction to certain foods or environmental allergens.
Symptoms of EoE vary from person to person and may include:
Gastroesophageal reflux (heartburn)
Food getting stuck in the throat due to narrowing (this is a medical emergency)
Stunted growth or poor weight gain in children
People with atopic dermatitis, asthma, or food or environmental allergies have a much
greater chance of developing EoE it. Some other conditions can cause eosinophils to
increase in number in the esophagus. Your healthcare provider will need to evaluate
you for these possible conditions. Family history of EoE is also a risk factor for
Your healthcare provider will take your medical history and will likely want to test
you for allergies. He or she will probably request an endoscopy by a gastroenterologist,
a specialist in digestive (stomach and swallowing) disorders. This is an outpatient
procedure that involves passing a thin, flexible endoscope with a camera through your
mouth and down your throat to look at your esophagus. The gastroenterologist will
check for physical signs of inflammation and an increased number of eosinophils. To
confirm the diagnosis, your gastroenterologist will likely need to take a biopsy,
or tissue sample, from your esophagus.
For treatment, you will need to work closely with an allergist and/or a gastroenterologist.
They’ll help you figure out what substances or foods to avoid. No specific medicines
can cure EoE, although certain medicines, such as corticosteroids and proton pump
inhibitors, and eliminating specific foods—diary, egg, wheat, soy, peanut, tree nuts,
and fish—from your diet can help reduce the redness and swelling in your esophagus.
You can help manage EoE by learning what substances cause your allergic reaction and
avoiding them. It is important to know that reactions related to EoE might take days
or weeks to develop. Keep this in mind when beginning a food elimination plan. It
might take some time after avoiding a particular food to determine whether that strategy
Sometimes the esophagus needs to be dilated (stretched) if it has narrowed.
The long-term complications of EoE are not clearly understood. If left untreated,
symptoms will continue and damage to the esophagus causing narrowing may happen.
Call 911 if you have:
When to call the healthcare provider
Call your healthcare provider if you have EoE and notice any of these symptoms:
Increasing weight loss
Increase in vomiting
Living with EoE
EoE is often a life-long condition. Management includes avoiding the foods or allergens
that cause the allergic reaction, or medications. It is important to work with your
allergen and gastroenterologist to develop a management plan that works best for you.
It can take patience to identify and then remove allergens from your diet. However,
your quality of life will improve as your management plan progresses.
Online Medical Reviewers:
- Freeborn, Donna, PhD, CNM, FNP
- Kirsi Järvinen-Seppo, MD, PhD
- Lehrer, Jenifer, MD