Eosinophilic esophagitis (EoE) is a disease that may mimic typical reflux. In this condition, a type of white blood cell, the eosinophil, appears in high numbers in the lining of the esophagus (the tube connecting the throat to the stomach). Patients with EoE may have a family history of this condition, or other allergic disease such as asthma, nasal allergies, eczema, or food allergy. Symptoms can be similar to heartburn, but may also include difficulty swallowing, a sensation of something “being stuck in your chest,” choking or vomiting, or even an impaction, where food must be removed from the esophagus with the aid of a camera (endoscopy). Currently, the only way to confirm the diagnosis of EoE is by a gastroenterologist taking a biopsy of the esophagus via endoscopy.
Researchers aren’t sure what causes some people to develop EoE, but for many people, particularly kids, food allergies seem to play a role. Environmental allergies may play a role in some people as well. Allergists can help patients with EoE identify potential triggers and improve their symptoms by educating patients on how to avoid those triggers.
For many patients, dietary avoidance of identified food triggers may be enough to control their symptoms. Other patients may require medications such as swallowed steroids (typically used for asthma) or specific antacids (known as proton pump inhibitors) to help control their symptoms.