There is a new type of food allergy that people who have asthma and nasal allergies need to be aware of. It’s called eosinophilic esophagitis, or EoE for short. Experts first identified it 15 or 20 years ago, but the number of people who have it has been steadily increasing with each year.
What is eosinophilic esophagitis?
Eosinophilic esophagitis is an inflammatory condition in the esophagus, which is the tube in your throat that leads from the mouth to the stomach (as opposed to your airways that lead to your lungs).
Eosinophils are a type of white blood cell that help to fight infection. However, they are not normally found in the esophagus, except in those who have this condition. When eosinophil numbers are too high, they can actually cause damage to the body, rather than protect it.
Esophagitis is a medical term that means an inflammation of the esophagus.
What happens when you have this condition?
People who have EoE collect excess amounts of these white blood cells, causing inflammation, scarring, and narrowing of the walls of the esophagus. When that happens, it makes it hard to swallow food. Babies and young children who have this condition may also complain of stomach pain, vomit frequently and stop eating. They may also fail to grow and develop.
Older kids and adults who have EoE also have trouble swallowing. In addition, food may get stuck in the esophagus and back up. In fact, this back up may be so severe that the person needs emergency care to remove the impacted food. They may also complain of heartburn or chest pain that is not relieved by the usual medication.
What causes EoE?
Experts aren’t really sure what causes this condition. But they do believe that it is more common in people who have asthma and both food and pollen allergies.
Elevated levels of eosinophils are common in people who have the following conditions:
- Crohn’s disease
- Ulcerative cholitis
- Some forms of cancer
How Is EoE Treated?
EoE is treated similarly to food allergies, since the greatest majority of cases are in people who have food allergies. So, this involves:
- Identifying the allergen using standard allergy testing
- Elimination diets, where common or suspected food allergens* are eliminated one-by-one from the diet
- Allergy medications, including inhaled steroids
- Pollen avoidance techniques
In severe cases, doctors may even recommend dilation of the esophagus.
*It is common for the food allergen to come from the same eight foods that cause 90 percent of food allergies: tree nuts, peanuts, cow’s milk, wheat, soy, eggs, fish and shellfish.
Even though this condition was discovered more than a decade ago, there is still much research and study to be done to understand it better. Better testing and monitoring techniques need to be developed. One place research is being done is at Ohio State’s Wexner Medical Center and the Nationwide Children’s Hospital in Columbus, Ohio. Researchers in those facilities are working together to study how to test for EoE and the best ways to treat it, as well as learning more about triggers for EoE.
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Kathi is an experienced consumer health education writer, with a prior career in nursing that spanned more than 30 years — much of it in the field of home health care. Over the past 15 years, she’s been an avid contributor for a number of consumer health websites, specializing in asthma, allergy, and COPD. She writes not only as a healthcare professional, but also as a lifelong sufferer of severe allergies and mild asthma, and as a caregiver for her mother with COPD.