When looking into reflux symptoms one of the relatively new things for doctors to consider is eosinophilic esophagitis (EoE). While considered rare, it’s becoming more commonly diagnosed. In fact, the American Partnership for Eosinophilic Disorders states that the current belief is that it is found in more than 1 in 2000 people and diagnosis has increased dramatically over the past 10 years.
Eosinophils are white blood cells. White blood cells are important to help us fight infection. Eosinophils are specifically important for fighting off infection and may also be increased during allergies.
The symptoms of EoE are similar to those of reflux and may include: reflux that doesn’t respond to medication, difficulty swallowing (dysphagia), nausea and/or vomiting, stomach pain, poor appetite and/or difficulty sleeping.
A doctor may decide to test for EoE if the patient has the above symptoms, or the doctor may find EE during a endoscopy scheduled for another purpose. Because the esophagus generally has very few eosinophils in it during typical GERD, the presence of eosinophils confirms the diagnosis.
If EoE is confirmed the next step is normally allergy testing as it can be caused by an allergic reaction to either an environmental or food allergen. This may include skin prick or patch testing.
Treatment may depend on the cause of the EoE. For example, if a specific food allergy is found during the allergy testing, avoiding that food may be enough to decrease the symptom of EE. Many people take steroids to help the body with the allergic reaction. Very few people need to be fed through a stomach tube.
If you suspect that EoE may explain your symptoms, talk to your doctor about your concerns. If you have already had an endoscopy, your doctor will be able to review the results with you. If you have not had one and if you have symptoms that are not being adequately treated with anti-reflux medications, your doctor may want to consider further diagnostic testing.