Eosinophilic Esophagitis (EE)

Eosinophilic Esophagitis (EE)

Eosinophilic esophagitis (EE) is a condition in which patients are found to have increased number of eosinophils on esophageal biopsy, and often symptoms of gastroesophageal reflux (acid in the esophagus). It is a condition that affects all ages but predominantly the young through mid-adulthood.

EE

EE

40% of adults and upwards to 80% of children are found to have allergy (sensitivity) to one or more foods that can be triggers to attract the eosinophils to the esophagus. Common foods are milk, egg, peanut, soy, and wheat, but many other foods have been also found to be triggers in select patients.

The food “allergy” in EE is different than other food allergy.  In EE, foods don’t cause rash or anaphylaxis but send a signal to the body from the lining of the esophagus. Food allergy can be tested in two ways:  prick testing on the arm or back (read in 15 minutes) and by patch testing on the back (read 72 hours later).

The most common symptoms of EE are nausea, vomiting, abdominal pain, weight loss, anemia (blood loss), difficulty swallowing, choking, and/or failure to thrive.

If a food or foods can be identified and restricted from the diet, patients may often be cured of EE. In some cases, the food(s) can be reintroduced in the diet and tolerated at a later time.

EE is easily treated and most patients have a quick and an excellent response to treatment. Patients with EE are usually unresponsive to anti-reflux medicines alone. The main medicines used in treatment are inhaled steroids which are swallowed instead of inhaled. Eosinophils are very sensitive to steroids and disappear when exposed to steroids. Inhaled (swallowed) steroids are SAFE and without side effects, even with long-term usage.

Are medications required over the long run? In many cases, they are – especially if a food or foods cannot be found to account for the eosinophils gathering in the esophagus.