Eosinophilic esophagitis occurs when large numbers of eosinophils (a type of white blood cell) build up in the esophageal lining, usually in response to food or environmental allergens. This chronic inflammation can cause the esophagus to stiffen or narrow, leading to swallowing difficulties and food impaction.
EoE is considered a chronic condition that typically requires ongoing management. Treatments may include dietary changes to remove trigger foods, acid suppression, swallowed topical steroids, and sometimes endoscopic dilation to carefully stretch narrowed areas.
Adults most often present with trouble swallowing solid foods, episodes of food getting stuck, and heartburn-like symptoms, while children may show feeding difficulties, abdominal pain, vomiting, or poor growth.
Call the office if you have increasing trouble swallowing, episodes of food getting stuck, poor symptom control despite treatment, chest pain, or weight loss. These changes may mean your treatment needs to be adjusted or that repeat evaluation is needed.
Seek emergency care immediately if food is stuck in your esophagus and will not pass, if you cannot swallow saliva, or if you develop severe chest pain, difficulty breathing, or signs of significant bleeding (vomiting blood or black, tarry stools). Food impaction is an emergency and often needs urgent endoscopic treatment.
Evaluation typically includes upper endoscopy with biopsies of the esophagus to look for eosinophils and characteristic visual changes. Providers also consider history of allergies, asthma, eczema, and may involve allergy testing to identify triggers.
Management focuses on reducing inflammation, preventing food impaction, and improving swallowing. Common approaches include elimination diets, proton pump inhibitors, swallowed topical steroids, and periodic monitoring with endoscopy.
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