Eosinophilic Esophagitis

Eosinophilic esophagitis (EE) is a disease characterized by swelling of the esophagus (the part of the body connecting the throat and the stomach) caused by an allergic white blood cell, the eosinophil. Symptoms of EE can range from severe heartburn, difficulty swallowing, food impaction in the esophagus, nausea, vomiting and weight loss. There appears to be some age-related differences in symptoms, with younger children having more symptoms of weight loss, and older children and adults having food impaction and difficulty swallowing.

It is not exactly clear what causes EE, although this disease may be related to other allergic diseases, particularly asthma. People with EE frequently have a personal or family history of other allergic diseases such as hay fever, food allergy and asthma. There have been studies showing an association between food and environmental allergies and EE.

The diagnosis of EE is generally made by performing a biopsy of the esophagus, with evidence of eosinophils infiltrating the esophageal tissue.

Treating EE is usually begun with a trial of avoidance of the foods to which the person has positive allergy tests initially. Corticosteroids are frequently used to treat EE when avoidance of allergic triggers unsuccessfully relieves symptoms. Steroids may be used as pills, such as prednisone or as a topical therapy, such as using inhaled steroids typically used for asthma, except that the medication is swallowed, not inhaled. This results in the delivery of the medication directly to the esophagus. Typically, medications for GERD are also given to patients with EE.

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