Overview
Eosinophilic (ee-uh-sin-uh-fil-ik) esophagitis (EoE) is a recognized chronic allergic/immune condition. A person with EoE will have inflammation of the esophagus. The esophagus is the tube that sends food from the mouth to the stomach.
In EoE, large numbers of white blood cells called eosinophils are found in the tissue of the esophagus. Normally there are no eosinophils in the esophagus. The symptoms of EoE vary with age. In infants and toddlers, you may notice that they refuse their food or are not growing properly. School-age children often have recurring abdominal pain, trouble swallowing or vomiting. Teenagers and adults most often have difficulty swallowing, particularly dry or dense, solid foods. The esophagus can narrow to the point that food gets stuck. This is called food impaction and it is a medical emergency.
Allergists and gastroenterologists are seeing many more patients with EoE. This is due to an increased incidence of EoE and greater physician awareness. EoE is considered to be a chronic condition and is not outgrown.
Other diseases can also result in eosinophils in the esophagus. One example is acid reflux. Proton-pump inhibitors (PPIs) are medications that help reduce stomach acid production. These drugs are commonly used to treat heartburn, GERD (gastroesophageal reflux disease) and other conditions caused by too much stomach acid. Proton-pump inhibitor responsive esophageal eosinophilia or PPI-REE is a condition that has the same symptoms and esophageal biopsy findings as EoE. However, after a trial of PPIs, symptoms resolve and repeat esophageal biopsies are normal.