Eosinophilic esophagitis is the inflammation of esophagus caused by abnormal levels of eosinophils in the blood. These abnormally high levels of eosinophils are the result of body’s response (allergic reaction) towards an allergen.
The esophagus is the muscular tube that connects mouth with stomach and propels swallowed food into the stomach. In eosinophilic esophagitis, the wall of the esophagus becomes filled with large number of eosinophils and causing swelling. In this article we give symptoms, diagnosis and treatment of eosinophilic esophagitis.
Symptoms of eosinophilic esophagitis:
- Difficulty in swallowing or dysphagia
- Heartburn
- Food impaction in esophagus
- Chest pain
- Abdominal pain
- Nausea
- Vomiting
- Coughing
- Failure to thrive
- Weight loss
There are some age related differences in symptoms that manifest. Younger children have more symptoms of weight loss where as older people have food impaction and difficult swallowing.
Diagnosis:
Eosinophilic esophagitis is diagnosed based on the symptoms. Upper gastrointestinal endoscopy is reliable way to diagnose inflammation in esophagus. At the time of endoscopy, furrows or ridges are seen in the esophagus wall. White exudate is also seen in the diagnosis.
Biopsy tests are done to confirm the finding. Eosinophilic esophagitis may not show up and it may be present even if the esophagus appears to be normal.
Skin tests are done to identify the foods that contribute to the disease.
Treatment:
Eosinophilic esophagitis is treated using several strategies including medical therapy, dietary modifications and mechanical dilatation of the esophagus. In medical therapy acid-inhibition medications and proton pump inhibitors are given to cure the symptoms.
Dietary modifications are done to rehabilitate the esophagus and mechanical dilatation is considered in the severe cases where the esophagus is progressed to stricture or severe stenosis.
