Symptoms of EoE, like difficulty swallowing, interfere with daily life. However, with early detection and appropriate treatment, patients can manage their symptoms effectively. Here, we will discuss the symptoms, diagnosis, and treatment of EoE.
Eosinophilic Oesophagitis (EoE) is a chronic inflammatory condition that affects the oesophagus, the tube connecting the throat and stomach. This disorder is characterised by an abnormal accumulation of eosinophils (a type of white blood cell) in the oesophageal lining. Eosinophils are important in the body’s defence against infections, but in many affected individuals, they accumulate in response to food and/or airborne allergens and can cause inflammation and tissue damage.
Symptoms
The symptoms of EoE can differ from person to person and can be mistaken for other gastrointestinal disorders. Some symptoms include –
DYSPHAGIA – Difficulty swallowing is a hallmark symptom of EoE. Patients may experience the sensation of food getting stuck in the throat or chest.
FOOD IMPACTION – In severe cases, swallowed food can become impacted in the oesophagus, leading to intense chest pain and a medical emergency.
HEARTBURN – EoE can cause heartburn or gastro-oesophageal reflux disease – like symptoms.
REGURGITATION – People may experience regurgitation of undigested food or acid into the mouth.
ABDOMINAL PAIN – Some individuals with EoE may experience abdominal discomfort or pain.
NAUSEA & VOMITING – EoE can lead to feelings of nausea and occasional vomiting.
Diagnosis
Diagnosing EoE involves a multi-step process to rule out other conditions and identify the presence of eosinophils in the oesophagus. The following steps are typically taken –
1. MEDICAL HISTORY & SYMPTOMS Your doctor will begin by taking a detailed medical history and noting any symptoms.
2. ENDOSCOPY A gastroscopy is performed to visualise the oesophagus and take biopsy samples. During this procedure, a thin, flexible tube with a camera on its tip is inserted through the mouth and into the oesophagus.
3. BIOPSY Tissue samples are collected during the endoscopy and analysed under a microscope to check for eosinophilic inflammation. The normal oesophagus has very few or no eosinophils in biopsy samples, but patients with EoE have a clearly defined abnormality when the density of eosinophils are equal to or greater than 15 per high power microscope field.
4. ELIMINATION DIET In some cases, an elimination diet is conducted to determine if specific food allergies trigger the symptoms.
Treatment
The treatment of EoE aims to manage symptoms, reduce inflammation, and prevent complications.
DIETARY MANAGEMENT – Identifying and eliminating trigger foods from the diet can help alleviate symptoms. This may involve working with a dietitian to create a personalised meal plan.
MEDICATIONS – Proton Pump Inhibitors such as esomeprazole, pantoprazole or rabeprazole to manage acid-related symptoms and help restore mucosal integrity. Topical corticosteroids, such as fluticasone or budesonide, can be used to reduce inflammation in the oesophagus.
OESOPHAGEAL DILATATION – In cases of severe narrowing of the oesophagus (strictures), dilation may be performed to widen the passage and improve swallowing.
ALLERGY IMMUNOTHERAPY – Some patients may benefit from allergy shots or sublingual immunotherapy to desensitise the immune system to specific allergens.
MONITORING – Regular follow-ups and endoscopies are essential to assess the response to treatment and make adjustments as necessary.
Eosinophilic Oesophagus is a chronic condition that requires ongoing management. If left untreated, EoE can lead to permanent scarring and narrowing of the oesophagus which increases the chance of food getting stuck. Early diagnosis and personalised treatment plans are crucial in improving the quality of life for individuals with EoE.
If you or someone you know is experiencing symptoms of EoE (like difficulty swallowing), it is essential to make an appointment with your doctor promptly to receive an accurate diagnosis and start appropriate treatment.
At Gastronorth, our experienced gastroenterologists perform gastroscopy to diagnose EoE and manage treatment of this condition to prevent long term complications.
Disclaimer – This article is for general information and educational purposes only. It is not a substitute for professional advice. Always consult a registered health professional regarding any health-related diagnosis or treatment options.
