Eosinophilic Esophagitis

Eosinophilic Esophagitis is still a poorly understood disorder. In essence, this condition affects the patient’s esophagus, which is the muscular tube which channels swallowed food into the stomach. In this disease, cells involved in allergic processes called eosinophils invade the esophagus and are found in high numbers in the esophageal tissue. Normally the esophagus should not have any eosinophils at all.

This condition usually manifests as feeding disorder and vomitting in young children to abdominal pain, difficulty swallowing, and food getting stuck in the esophagus from ages 8 years old and older. A gastroenterologist (Stomach specialist) can pass a scope into the esophagus which can reveal ulcerations, thickened lining and creases as shown below

It is not clear what causes this condition, but food allergy has been demonstrated to play a role. There has also been studies demonstrating that inhaled allergens could also contribute to this disease.

Treatment of this disease is challenging and should include evaluation for food allergy with appropriate food avoidance as well as topical steroids. Mepolizumab, a biologic antibody designed to reduce eosinophils have been shown to be effective in some investigational studies. Patients should be referred to a Gastroenterologist and a qualified Allergy & Immunology specialist for proper evaluation.

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