Eosinophilic esophagitis, sometimes referred to as EE or EoE, is a condition that causes inflammation and damage to the esophagus.
C.S. Mott Children’s Hospital provides specialized care for children and adolescents with eosinophilic esophagitis. Our collaborative approach involves pediatric gastroenterologists and food allergy specialists with expertise in the care of children with these complex conditions.
What is eosinophilic esophagitis?
The esophagus is the tube that connects the mouth to the stomach. Eosinophilic esophagitis occurs when there are a higher number of a particular type of white blood cell (eosinophils) that migrate to the esophagus in response to a stimulus. When the eosinophils migrate to the esophagus, they can cause swelling and inflammation, making it difficult to swallow. Sometimes the reaction can be immediate, and sometimes it can be delayed, making it difficult to determine the cause of the reaction.
Symptoms of eosinophilic esophagitis
Common signs of EoE may include:
- difficulty swallowing
- food getting stuck in the throat
- chest pain
- refusing to eat (especially in toddlers), or increased sensitivity to some food textures
- reflux that doesn’t respond to medications
Some individuals will have identifiable specific allergies to foods which can be eliminated, whereas other will have no specific identifiable food allergen.
Each child may experience symptoms differently, and it’s important to note that many of these symptoms are also found in children with gastroesophageal reflux disease.
Diagnosing eosinophilic esophagitis
The C.S. Mott Children’s Hospital team has extensive experience diagnosing EoE and distinguishing between this condition and others with similar symptoms.
Your physician will begin with a physical examination and a thorough discussion of your child’s symptoms. Based on your risk factors, your doctor might recommend an upper endoscopy to examine the upper gastrointestinal tract to determine if you have EoE.
Allergy testing might also be conducted to identify “trigger foods” that are causing inflammation in the esophagus.
Treatment of eosinophilic esophagitis
Once a definitive diagnosis of EoE has been confirmed, we will work with your family to develop a personalized treatment plan for your child.
Many treatment plans include the following:
- Medications: primarily including swallowed medications (corticosteroids, usually budesonide) that reduce inflammation rapidly and stop the eosinophilic response to stimuli
- Diet modifications: potentially eliminating specific foods that trigger an eosinophilic response. For some patients, single food elimination diets are effective, while others may find better success with six food elimination diets (milk products, soy, eggs, wheat, peanuts/tree nuts, and shellfish).
- Both medication and diet modification: in some patients, both types of treatment may be necessary
There is no cure for eosinophilic esophagitis, but with careful treatment and follow-up care, your child will be able to manage his or her symptoms and thrive.
Your care may include specialists in pediatric allergy and pediatric gastroenterology. Our physicians will work closely with your primary care provider and other specialists in the community as needed to coordinate your treatment and provide the best possible care and support for your family.