Digestive Clues
Identifying these signs early can be essential for managing EoE effectively.
Signs of EoE
Difficulty Swallowing (Dysphagia)
Dysphagia is one of the most common symptoms of EoE, making it difficult for individuals to swallow food or liquids. Many patients describe a sensation of food getting "stuck" in the esophagus.
Food Impaction
Food impaction occurs when food physically blocks the esophagus, leading to a painful and often frightening experience. This symptom may require emergency medical attention to dislodge the food.
Chest Pain or Discomfort
The inflammation caused by EoE can result in chronic chest pain or discomfort, which can sometimes be mistaken for heartburn or acid reflux. This pain typically worsens after eating and is due to esophageal irritation.
Abdominal Pain
EoE can cause pain in the upper abdomen, which often arises after eating. This discomfort is due to the inflammation and pressure in the esophagus as it struggles to pass food to the stomach.
Regurgitation or Vomiting
Some individuals with EoE experience frequent regurgitation or vomiting. This happens as the esophagus tries to expel food rather than allow it to move downward.
Persistent Cough or Throat Clearing
Chronic coughing or frequent throat clearing may occur as a result of irritation in the esophagus. This symptom is particularly common in children with EoE but can also affect adults.
Decreased Appetite and Weight Loss
Because eating can be uncomfortable or painful, many people with EoE experience a decrease in appetite and, subsequently, unintended weight loss.
Malnutrition
Over time, in more serious cases of EoE, malnutrition can occur. As people avoid certain foods or eat less to prevent symptoms, they may miss out on essential nutrients.
Understanding EoE
Eosinophils are a type of white blood cell that plays a key role in the body's immune response, particularly in fighting parasites and in allergic reactions. When these white blood cells build up in the esophagus, it can lead to tissue damage and dysfunction. This buildup can inflame or injure the esophageal tissue, which can lead to difficulty swallowing or cause food to get stuck when you swallow. Studies suggest that EoE occurs mostly as a result of food triggers.
An estimated three-quarters of affected cases occur in white males. People with atopic dermatitis, asthma or food/environmental allergies are also most likely to suffer from EoE.
Treatment Options
EoE was only recently identified in the early '90s. As a result, more and more research is being conducted to better understand this disease. Some of the most common treatment options for EoE include:
Dietary Management
- Elimination diet: Removing common food allergens from the diet to identify triggers, such as milk and dairy, wheat, eggs, soy, peanuts, tree nuts, fish and shellfish.
- Elemental diet: A temporary liquid diet consisting of amino acid-based formulas, often used in severe cases. Research suggests that an elemental diet is highly effective for both adults and children with EoE, with remission rates of up to 96%.
- Reintroduction: Gradually reintroducing foods to identify specific triggers.
Medications
Proton Pump Inhibitors (PPIs): Often used to reduce acid production and inflammation.
Topical steroids: Swallowed steroids (like fluticasone or budesonide) to reduce esophageal inflammation.
Systemic steroids: Used in more severe cases but typically avoided long-term due to side effects.
Endoscopic Dilation
A procedure to stretch the esophagus if it has become narrowed due to inflammation and scarring. This procedure should relieve blockages, making eating and swallowing much easier.
Monitoring
Regular follow-ups with an allergist and gastroenterologist to manage the condition and adjust treatment as needed.
Lifestyle and Dietary Adjustments
Adjusting meal sizes and taking small bites can help reduce symptoms, as larger portions may worsen food impaction and dysphagia.
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