What is Eosinophilic Esophagitis?
Eosinophilic esophagitis is an inflammatory condition in which swelling occurs in the esophagus, which then becomes narrowed and does not contract properly. The esophagus is a tubular structure connecting the mouth to the stomach. In this condition, you will have an overabundance of a specific type of white blood cell (the eosinophil) in the esophagus. This is a very rare condition observed in 1 in 10,000 people and seen in both adults and children.
Causes of Eosinophilic Esophagitis
Eosinophils are a type of white blood cell present more abundantly in your digestive tract. The esophagus lining reacts to allergens, such as food or pollen, causing multiplication of eosinophils and production of a protein that causes inflammation in the esophagus. Inflammation can lead to scarring, narrowing and formation of excessive fibrous tissue in the lining of your esophagus.
Symptoms of Eosinophilic Esophagitis
Symptoms of Eosinophilic esophagitis include:
- Difficulty in swallowing
- Food gets stuck in the esophagus after swallowing
- Pain in the center of the chest that does not respond to antacids
- Regurgitation (backflow of undigested food)
- Difficulty feeding in infants
- Difficulty eating
- Vomiting
- Abdominal pain
- Difficulty in swallowing
- Poor growth, malnutrition and weight loss
Diagnosis of Eosinophilic Esophagitis
Your healthcare provider performs a physical examination and notes your medical history looking for signs and symptoms of the disease. Special procedures such as upper endoscopy and biopsy may be ordered. The endoscopy sometimes reveals rings, white plaques (patches) or grooves in the esophagus confirming the diagnosis. Biopsy samples reveal an unusually large number of eosinophils in the esophageal tissue lining.
Treatment of Eosinophilic Esophagitis
Treatment of eosinophilic esophagitis includes:
Medication
Antacid medications or proton pump inhibitors, and steroids are the most commonly used medication for both the control of the inflammation and direct suppression of the eosinophils. Proton-pump inhibitors can be taken orally whereas steroid medications can be taken either orally, topically or in the form of injections. These medications need to be taken for a long time to treat the eosinophilic esophagitis effectively and to keep the inflammation from coming back.
Dietary management:
In case food allergies may be the suspected cause of eosinophilic esophagitis, you will have to avoid foods that may cause allergic reactions from your diet as well as consume soft and easily digestible foods.
Esophageal dilation:
This is a minimally invasive procedure in which your healthcare provider dilates or stretches your esophagus, using an endoscopy. This is useful in treating patients with food blockage in their esophagus.
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