Eosinophilic esophagitis, also known as EoE, is an allergic condition that causes swelling in the esophagus. This swelling can lead to difficulty swallowing, pain in the abdomen, heartburn, and vomiting. In children, other signs that EoE may be present include poor growth, weight loss, poor appetite, and even refusal to eat. EoE is caused by ingesting proteins in certain foods that trigger an allergic response and inflammation, specifically in the esophagus and other parts of the gastrointestinal tract. The involvement of the gastrointestinal system as well as the allergic component means that treating EoE should be a collaborative effort between a gastroenterologist and an allergist or immunologist. The gastroenterologist will usually perform an EGD, or endoscopy, to biopsy esophageal tissue for the presence of abnormally elevated eosinophil levels. An elevation of this type of white cell in the esophagus is the cause of the inflammation and is the diagnostic factor that needs to be confirmed in cases of eosinophilic esophagitis. Once the diagnosis is made, an allergist or immunologist is usually consulted to help identify specific trigger foods using a variety of available testing methods. While skin prick testing for foods is often used, our practice also uses food patch test placement which is more effective in identifying delayed food reactions that skin testing may overlook.
This condition may result in eliminating a variety of foods from the EoE patient’s diet. To ensure nutritional needs of the patient are being satisfied with the dietary changes required, our physician may choose to refer EoE patients to a registered dietitian or nutritionist for consultation and treatment.