Living with EoE
Eosinophilic esophagitis, also known as EoE, is a chronic disease characterized by inflammation of the esophagus, the tube that connects the mouth to the stomach. Diet can have a large impact on the severity of EoE. This article will explore EoE, its causes, symptoms and treatment options.
EoE Foods to Avoid
- Dairy.
- Eggs.
- Wheat.
- Soy.
- Peanuts.
- Tree nuts.
- Fish.
- Shellfish.
Understanding EoE
Eosinophils are a type of white blood cell that plays a key role in the body's immune response, particularly in fighting parasites and in allergic reactions. EoE is an inflammatory condition that occurs when the eosinophils build up in the esophagus, leading to tissue damage and dysfunction. This buildup can inflame or injure the esophageal tissue, which can lead to difficulty swallowing or cause food to get stuck when you swallow. Studies suggest that EoE occurs mostly as a result of food triggers.
An estimated three-quarters of affected cases occur in white males. People with atopic dermatitis, asthma or food or environmental allergies are also most likely to suffer from EoE.
Symptoms of EoE can differ between children and adults, though there is some overlap.
Signs in Adults
- Difficulty swallowing (dysphagia).
- Food impaction (food getting stuck in the esophagus).
- Chest pain or heartburn.
- Upper abdominal pain.
- Persistent nausea and vomiting.
Signs in Children
- Feeding difficulties.
- Vomiting.
- Abdominal pain.
- Failure to thrive (poor growth).
- Difficulty swallowing (similar to adults).
Treatment Options
EoE was only recently identified in the early '90s but is now considered a major cause of digestive system illness. As a result, more and more research is being conducted to better understand this disease. Some of the most common treatment options for EoE include:
Dietary Management
- Elimination diet: Removing common food allergens from the diet to identify triggers, such as milk and dairy, wheat, eggs, soy, peanuts, tree nuts, fish and shellfish.
- Elemental diet: A temporary liquid diet consisting of amino acid-based formulas, often used in severe cases. Research suggests that an elemental diet is highly effective for both adults and children with EoE, with remission rates of up to 96%.
- Reintroduction: Gradually reintroducing foods to identify specific triggers.
Medications
- Proton Pump Inhibitors (PPIs): Often used to reduce acid production and inflammation.
- Topical steroids: Swallowed steroids (like fluticasone or budesonide) to reduce esophageal inflammation.
- Systemic steroids: Used in more severe cases but typically avoided long-term due to side effects.
Endoscopic dilation
A procedure to stretch the esophagus if it has become narrowed due to inflammation and scarring. This procedure should relieve blockages, making eating and swallowing much easier.
Monitoring
Regular follow-ups with an allergist and gastroenterologist to manage the condition and adjust treatment as needed.
EoE Prognosis
EoE isn’t especially common–only affecting about one in 2,000 people–and therefore lots of research to further understand it is still being conducted. This also means that there isn’t much information about the condition’s overall prognosis.
Studies suggest that EoE doesn't appear to limit life expectancy or cause esophageal cancer. With proper treatment, quality of life and life expectancy shouldn’t be greatly impacted. If left untreated, however, EoE can lead to esophageal narrowing, strictures and difficulty swallowing, which may require more invasive treatments.
EoE Essentials
Understanding EoE involves being able to identify symptoms, knowing the diagnostic and treatment approaches and familiarizing yourself with your own food triggers. Effective management of EoE typically includes a combination of dietary changes, medications and regular monitoring to control inflammation and prevent complications.
If you have any of these symptoms, it is strongly recommended that you get in touch with your doctor as soon as possible. They can help you identify and curate a plan that works for your lifestyle, symptoms and specific needs.