Eosinophilic Esophagitis: Symptoms & Treatment 

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Before the 1980s, people suffering from eosinophilic esophagitis or EoE are only assumed to have gastroesophageal reflux disorder (GERD) or acid reflux. The issue, though, is that the treatment for GERD cannot treat EoE. It was not until around 40 years ago that physicians learned that GERD is not the cause of EoE, and though they are very similar, these are two entirely different conditions.

EoE is a chronic immunological medical condition with the same symptoms as GERD, including difficulty in swallowing and abdominal pain. Leukocytes should stay in the gastrointestinal tract, so it occurs once the eosinophils create a tube within the esophagus connecting your mouth to the stomach. Allergies typically cause white blood cells to transfer to the throat. Further, it will require the patient to undergo eosinophilic esophagitis treatment once diagnosed.

EoE is a children’s illness for several years, but now, more adults are becoming diagnosed with the condition. Researchers believe that it is partially due to physicians being more informed about it, but also because there are more reports of related symptoms such as asthma and allergies.

Symptoms include:

  • Dysphagia (trouble swallowing)
  • Chest pain and upper abdominal discomfort
  • Vomiting
  • Choking (especially on food, a medical emergency)

All these are also GERD symptoms, which is why they were mistaken to be the same. The best approach to identifying EoE is that individuals who have the illness do not get better with medication for acid reflux.

Treatment for Eosinophilic Esophagitis

EoE is a chronic relapsing illness. Thus, many people will need long-term eosinophilic esophagitis treatment to regulate the symptoms. The treatment involves several of the following:

Allergy Test-directed Diets

The physician may eliminate some foods from your eating plan if you got diagnosed with particular food allergies following a patch testing and prick skin test. It allows some people to manage their EoE.

Empiric Elimination Diets

Removing significant food allergens from your diet before any allergy screening is also an acknowledged EoE treatment. Prohibited foods typically include milk, eggs, nuts, wheat, soy, and seafood. These diets are seen to be effective in managing EoE. It can be challenging to practice, so the aid of a nutritionist with a background in EoE is recommended. Foods are incorporated one by one along with follow-up endoscopies to ensure the illness stays under control.

Elemental Diets

All protein sources become eliminated from this diet. The patient gets nutrition from amino acid formula and natural sugars and fats. All the other foods get taken away from the eating plan. It might require a feeding tube, as many people dislike the taste. This method is usually reserved for toddlers with different food allergies and whose body does not respond to other methods of treatment.

Topical Steroid 

No drugs are presently approved by the U.S. Food and Drug Administration to treat EoE. However, medicines are shown to decrease the number of eosinophils in the esophagus and work on improving symptoms. Corticosteroids that regulate inflammatory responses are the most useful treatments available for people with EoE.

Ingesting low doses of corticosteroids are by far the most viable treatment, and various types of swallowed corticosteroids are obtainable. Initially, high doses might be needed to manage swelling, but these are also associated with more side effects. As a result, when the inflammation of the esophagus is adequately regulated, the dosage of an oral corticosteroid will be kept to the lowest dosage required to maintain control.

Proton-pump inhibitors that regulate the level of acid released were also used to diagnose and manage EoE better. Many patients adapt well with the proton-pump inhibitors and also have a significant reduction in eosinophils and swelling when biopsy and endoscopy are followed up. These medications can also strengthen the effects of EoE without worsening inflammation. Experts are now trying to use them to control EoE. Continuous monitoring by the practitioner who is well informed about EoE treatment is essential.

EoE is a very complicated condition. It is vital for patients to speak with their gastroenterologist for guidance on the treatment and to figure out when endoscopies are necessary to determine if the problem is slowly improving or not. 

Patients also have to cooperate with an allergist/immunologist to figure out if allergies have a crucial role. They will also be able to determine if you have to eliminate any food from your diet and assist you in managing related health issues such as immunodeficiency disorders. If you go on a specific diet for your EoE treatment, you should meet a registered dietitian, as well.