There are several illnesses that look like GERD but are actually separate illnesses. One of those illnesses is Eosinophilic Esophagitis (EoE). EoE is an allergic disorder in which the cells lining the esophagus get inflamed and become filled with white blood cells called eosinophils. EoE is more common in patients who also have other allergic conditions like asthma, eczema or hay fever.
Symptoms of EoE include: swallowing difficulties, chest pain or heartburn, abdominal pain, nausea and vomiting and (in children) failure to thrive. These symptoms so closely mimic those of acid reflux that it can be hard to distinguish between the two without accurate testing.
Often times EoE sufferers find no relief from their pain by the use of traditional reflux medications. That may lead a physician to further testing. EoE is diagnosed through a scope in which esophageal tissue is biopsed and tested for eosinophils. Now here is the tricky part, severe GERD can also cause increases in eosinophils but the amounts tend to be far less than those with EoE.
Once diagnosed with EoE patients are generally treated with acid controlling medications as a swallowed steroid fluticasone propionate (1). The steroid acts as an anti-inflammatory and the PPI's help to heal acid damage. Patients then have to determine what allergy is causing the problem and eliminate that food or trigger from their diets. In severe cases of EoE patients may have to rely on elemental feedings for nourishment.
Recent research has located a locus on chromosome 5 that is associated with an increase in EoE (2). Locating the gene can help researchers to develop more targeted therapies to help treat those dealing with this painful condition.