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Allergy Glossary

Eosinophilic Esophagitis Treatment

Eosinophilic esophagitis is an inflammatory condition of the esophagus. The esophagus is the part of the digestive tract which leads from the mouth to the stomach. This disease was described around the year 2000, initially in children and later in adults. In adults, it is associated with difficulty in swallowing; food impaction; chest pain; and stricture formation in the esophagus. In children, symptoms include vomiting and regurgitation, feeding disorders and oral aversion, food impaction and a general failure to thrive.

The cause of the disease is not known. It is more common in atopic subjects. In some cases, food allergy is implicated, but more often patients are allergic to inhalants.

Endoscopic findings that might signal eosinophilic esophagitis include rings, stricture, furrow or straight lines, white spots, and a small-caliber esophagus. But in 30% of patients, endoscopic exams turn up normal.

Eosinophils are inflammatory cells which are usually scarce in the esophagus, but in this condition they infiltrate the wall of the esophagus. This has to be confirmed by taking various biopsies from different parts of the esophagus, and carefully looking them under the microscope.

The treatment consists on antiinflamatory medications. The most commonly used ones are topical steroids (i.e. asthma sprays which are swallowed instead of inhaled). If a food allergy is certainly diagnosed, that foodstuff should be avoided. Some patients need to undergo an even more restricted diet to improve symptoms. When the esophagus becomes narrow and rigid, some endoscopical interventions may be necessary.