Eosinophilic esophagitis (patient information)

Eosinophilic esophagitis
Overview
What are the symptoms?
What are the causes?
Who is at highest risk?
Diagnosis
When to seek urgent medical care?
Treatment options
Where to find medical care for Eosinophilic esophagitis?
Prevention
What to expect (Outlook/Prognosis)?
Possible complications
Eosinophilic esophagitisOn the Web
Ongoing Trials at Clinical Trials.gov
Images of Eosinophilic esophagitis
Videos on Eosinophilic esophagitis
FDA on Eosinophilic esophagitis
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Eosinophilic esophagitisin the news
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Directions to Hospitals Treating Eosinophilic esophagitis
Risk calculators and risk factors for Eosinophilic esophagitis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Esophagitis is a general term for any inflammation, irritation, or swelling of the esophagus, the tube that leads from the back of the mouth to the stomach.

What are the Symptoms of (Disease name)?

The symptoms of the eosinophilic esophagitis are as follows:

• Difficulty swallowing
• Reappearance of ingested food in the mouth
• Cough
• Chest pain
• Food impaction
• Abdominal pain
• Vomiting
• Nausea

What Causes (disease name)?

• The causes of EoE are the food and pollen react with the lining of the esophagus, these allergens cause the multiplication of eosinophils in the layers of the esophagus and produce a protein that causes inflammation.
• The inflammation further cause scarring, excessive fibrous tissue deposition over the lining of the esophagus eventually leading to difficulty in swallowing.
• The difficulty in swallowing can sometimes worsen to cause food impaction and additional symptoms such as chest pain.

Who is at Highest Risk?

• The risk factors of EoE are as follows
• Common in both children and adults,
• Male gender
• Cold and dry climate
• EoE is common in people with a history of European ancestry
• Summer and fall
• Positive family history of EoE
• History of allergies such as asthma, industrial exposures, environmental allergies, chronic respiratory disease, food allergies and atopic dermatitis.

Diagnosis

• There are no specific diagnostic markers to diagnose the EoE patients.
• Although not specific, elevated serum IgE levels are identified in majority patients.
• An increased peripheral eosinophil count is also seen in majority patients.
• There are 3 main ways in which food allergies can be detected in EE are Skin prick testing, Blood allergy testing, Atopy patch testing.
• The barium swallow of the esophagus shows multiple rings associated with eosinophilic esophagitis.
• There are no MRI or CT scan findings associated with EoE. however, an MRI or a CT scan may be helpful in the diagnosis of complications of EoE such as tears, perforation strictures etc

When to Seek Urgent Medical Care?

• Patients should seek medical care where they have the following symptoms
• Difficulty swallowing
• Reappearance of ingested food in the mouth
• Cough
• Chest pain
• Food impaction
• Abdominal pain
• Vomiting
• Nausea

Treatment Options

• The optimal treatment of eosinophilic esophagitis remains uncertain.
• An eight-week course of therapy with topical corticosteroids (fluticasone or budesonide) may be used as the first-line pharmacologic therapy.
• Allergen elimination usually leads to improvement in dysphagia and reduction of eosinophil infiltration.
• Esophageal dilation of is generally reserved for refractory cases with esophageal stricture.

Where to find Medical Care for (Disease name)?

Medical care for (disease name) can be found here.

What to Expect (Outlook/Prognosis)?

• The prognosis of the EoE is as follows:
• EoE is a relatively newly recognized disease, there is very limited data on the causes, natural history, prognosis, diagnosis, and management of these patients.
• The long-term prognosis of the EoE is unclear but patients diagnosed with EoE have an unaffected lifespan.
• Patients should be counseled that although it is a chronic disease, it is a benign condition.
• Patients who are untreated or have discontinued the treatment have progression of their symptoms.
• The EoE patients with a narrow esophageal lumen are resistant to the corticosteroid treatment and require many esophageal endoscopic procedures..
• The dysphagia is common in patients with increased eosinophil count in the blood.
• The EoE is restricted only to the esophagus sparing the stomach and the duodenum.
• A common concern for the patient and their families is what is the chance of that EoE may progress to a malignancy if untreated, EoE does not progress into metaplasia or dysplasia or esophageal cancer.

Possible Complications

• The complications of the EoE are as follows:
• Scarring of esophagus-leading to dysphagia
• Esophageal stenosis- causing food stuck
• Tears or perforation during the endoscopy or retching leading to [[boerhaave syndrome]

Sources

http://www.nlm.nih.gov/medlineplus/ency/article/000434.htm