Eosinophilic esophagitis (EoE) is a rare and chronic autoimmune disorder that was identified only in the early 1990s. It is known to affect approximately one in 2,000 people. In this condition, a type of white blood cell called eosinophils starts accumulating in the esophagus’s lining. As a result, the esophageal tissues become inflamed. Here are some known and common signs of eosinophilic esophagitis, causes, risk factors, diagnosis, and treatment options.

Common signs of eosinophilic esophagitis
A person with EoE has an inflamed esophagus with a high number of eosinophils. When the inflammation is chronic, it leads to the development of several symptoms, difficulty in swallowing or dysphagia being the primary sign. Most other symptoms of the condition differ based on age.

Common signs of eosinophilic esophagitis in adults:

• Food often gets stuck in the esophagus after swallowing, also called impaction.
• Chronic chest pain is experienced in the center of the chest. There is no relief from the pain even after taking prescriptions.
• There is regurgitation or backflow of undigested food through the esophagus.

Common signs of eosinophilic esophagitis in children:

• Infants can experience difficulty feeding.
• Young children may find it hard to eat and swallow solid foods.
• There are frequent instances of vomiting and nausea.
• Most kids experience persistent pain in the stomach
• Some children may experience impaction when food gets stuck in the esophagus after swallowing.
• Some children do not respond to GERD treatments, triggering the symptoms.
• In many cases, kids with EoE fail to thrive, including poor growth development, low BMI levels, and malnutrition.

In severe cases, affected persons may experience chest pain. In addition, there might be shortness of breath along with pain in the arm or jaw. In such cases, seeking immediate medical care or going to a nearby emergency room is important.

Causes and risk factors of eosinophilic esophagitis

Eosinophils belong to a category of white blood cells that are usually found in the digestive tract. With eosinophilic esophagitis, a person has an allergic reaction to an external trigger that causes the eosinophils to collect in the esophagus. The reaction may occur in the following manner.

• Reaction of the esophagus
  The internal lining of the esophagus may react to environmental allergens like pollen or specific types of foods.
• Multiplication of eosinophils
  As the esophagus reacts to the allergens, the immune system may cause eosinophils to accumulate and multiply in the esophageal lining. When the eosinophils release a protein in excess, it leads to inflammation.
• Damage to the esophagus
  The inflammation causes scarring and narrowing of the esophagus. In addition, excess fibrous tissues build up in the esophageal lining.
• Development of signs of eosinophilic esophagitis
  With the esophagus becoming narrow, affected persons start to experience the various symptoms of EOE, including dysphagia and impaction.

There are certain factors that make a person more susceptible to EoE. Here are some common risk factors for eosinophilic esophagitis.

• Climate
  Those who live in dry or cold conditions are at a higher risk of developing the condition than those staying in places with warmer and humid climates.
• Season
  There is a higher probability of being diagnosed with EoE during the spring and fall, since the level of pollen and other allergens is higher during these times.
• Gender
  It is observed that men are more prone to eosinophilic esophagitis than women.
• Family history
  In some cases, genes can play a role in the development of the condition. The risk is higher when a close family member, like a grandparent, parent, or sibling, has EoE.
• Pre-existing allergies and asthma
  Those with pre-existing environmental allergies, atopic dermatitis, asthma, or chronic respiratory disease are more susceptible to developing the condition.

Diagnosis of eosinophilic esophagitis
In general, the signs of eosinophilic esophagitis are quite similar to those of gastroesophageal reflux disease or GERD. Therefore, it is crucial to consult an allergist and a gastroenterologist to get the right diagnosis. The process of diagnosis involves undergoing a complete health history and food allergy testing. In addition, upper endoscopy and biopsy are also used for diagnosis of EoE. Biopsy involves looking for an unusually large number of eosinophils in the esophageal tissue. This is done because the esophagus may look normal even if a person has eosinophilic esophagitis. Therefore, biopsy samples or tissue samples will give accurate conclusions.

Treatment options
Depending on the causes and the severity of the signs of eosinophilic esophagitis, a health practitioner will recommend a treatment plan. Some of the common treatment options include the following.

• Prescription options
  These are given to manage the inflammation of the esophagus. Some prescribed options also help in lowering the level of acid in the stomach. These help in alleviating the discomfort caused by the symptoms.
• Intravenous therapy
  These are targeted therapies that are administered intravenously to lower the intensity of inflammation in the esophagus.
• Esophageal dilatation
  This treatment option is usually recommended when the esophagus becomes too narrow. Esophageal dilation is done while doing endoscopy. The process involves the insertion of a balloon through a tube positioned in the throat. The balloon is blown up to stretch the part of the esophagus that has become narrow due to the condition.
• Elimination therapy
  This is recommended under the supervision of an allergist. The therapy involves eliminating from one’s meals all the foods that may be a possible trigger for allergic reactions. Thus, an allergist may recommend that one stop eating tree nuts, fish, peanuts, shellfish, dairy products, wheat, soy products, and eggs. Then, tests are done to check whether one has allergic reactions to other foods. These foods are also eliminated from one’s meals. Then, symptoms are monitored to ascertain if they worsen or improve. This way, some foods are slowly eliminated over time to lower the risk of allergic reactions and avoid triggers that can cause signs of EoE to occur.