Eosinophilic Esophagitis (EoE)

Eosinophilic Esophagitis – Eosinophilic Esophagitis (EoE) is a chronic autoimmune disease where the body mistakenly sends eosinophils (white blood cells) to attack the esophagus associated with food allergies.

Is EoE an Autoimmune Disease?

Yes, EoE is an autoimmune disease. When I eat something I’m allergic to, my body will attack itself. More specifically, eosinophils (white blood cells) will gather in the esophagus and causes inflammation and swelling. Which then results in the food getting stuck in the esophagus.

It is different from anaphylaxis because EpiPens won’t do anything to resolve it. There is no cure for EoE and it is managed through diet changes and sometimes special dietary formula supplements.

Related Autoimmune Diseases: Achalasia, Celiac Disease

What causes Eosinophilic Esophagitis?

EoE is relatively new in the medical world, which is one reason why it takes people so long to reach this diagnosis. Doctors are just starting to explore the possibility of environmental allergies causing some people to have EoE.

While the exact cause of EoE is not yet known, the general belief is that it’s typically caused by an immune response to specific foods. Many patients with EoE have food or environmental allergies.

Researchers have identified a number of genes that play a role in EoE, including a recently discovered gene, calpain14 (CAPN14), that is expressed primarily in the esophagus. These pathways may provide new direction to diagnose, monitor and treat EoE in the future.

Who is affected by Eosinophilic Esophagitis?

Eosinophilic Esophagitis (EoE) is a rare autoimmune disease, but increasing in prevalence with an estimated 1 out of 2,000 people affected. EoE affects people of all ages and ethnic backgrounds. While both males and females may be affected, a higher incidence is seen in males. People with EoE commonly have other allergic diseases such as rhinitis, asthma, and/or eczema. Certain families may have an inherited tendency to develop EoE.

Establishing an EoE Diagnosis

In order to establish and EoE diagnosis, you must see a gastroenterologist and/or an allergist for a patient evaluation. The evaluation paired with your expressed symptoms could be consistent with eosinophilic esophagitis. Since EoE can mimic other conditions, more common diseases such as gastroesophageal reflux disease (GERD) must first be ruled out.

EoE Biopsy

When you have your biopsy, your esophagus may be sore or tender for a few days. Your gastroenterologist may also use a balloon to dilate your esophagus which may also cause discomfort. You might want to keep soft foods on hand for the next few days while you heal.

EoE Bloodtests

• ANA – Anti-nuclear antibody blood test
• Eosinophil count
• IgE level
• Your allergist may recommend a blood test for food allergies

Symptoms of Autoimmune Eosinophilic

Symptoms of Autoimmune Esophagitis can vary depending on age. Infants, toddlers and children may show different signs than teens or adults. Either way, symptoms can include:

• Dysphasia – Difficulty swallowing
• Impaction – Food getting stuck in the throat
• Regurgitation
• Chest pain or heart burn
• Abdominal pain or discomofort
• Malnutrition
• Poor appetite

Eosinophilic Esophagitis Treatments

There are a few Eosinophilic Esophagitis treatment methods. First, I will share with you more about EoE diet, then about vitamins and lastly, some medications, if necessary.

Diet for Eosinophilic Esophagitis

Follow your doctor’s EoE diet orders. If they recommend to cut anything out of your diet, follow their advice. You cannot have a “cheat” day and expect everything to be fine. Many doctors will say it can take up to 90 days for your body to fully expel any of your triggers absorbed by your body. Working with your doctors, you may find an appropriate time to reintroduce some foods into your diet. This must be done very carefully and under their supervision and guidance.

Vitamins and Wellness Routines

I also recommend increasing your vitamins and typical wellness routines at this time because you will be admitted to a hospital or outpatient center for this procedure.

EoE Prescriptions

• Your Gastroenterologist will most likely put you on a prescription dose of Omeprazole. After further testing, your doctor may or may not keep you on this medication.
• If your endoscopy and biopsies come back positive for EoE, you may be required to supplement your diet with a special prescription nutrient formula.
• In extreme cases, you may use a feeding tube. Occasionally, steroids may be prescribed as a treatment option, but this has yet to be approved by the FDA

Get your Questions Answered about EoE