What Is Eosinophilic Esophagitis?
Eosinophilic esophagitis (EoE) refers to the inflammatory condition of the esophagus. The esophagus is the organ connecting the stomach and the mouth. Eosinophilic esophagitis is a chronic condition. It occurs when the eosinophils accumulate in the esophagus.
What Is Eosinophil?
Blood has different components, namely red blood cells, white blood cells, plasma, and platelets. Eosinophils belong to the white blood cells. White blood cells are important components of immunity mediators. Eosinophils especially function during an allergic reaction.
What Are the Causes?
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Allergies such as hay fever, allergic rhinitis, asthma, and atopic dermatitis.
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Esophageal strictures (abnormal narrowing of the esophagus).
However, the exact cause of eosinophilic esophagitis is unknown.
What Are the Signs and Symptoms?
The symptoms might vary between adults and children.
Adults:
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Regurgitation (expulsion of undigested food).
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Dysphagia (difficulty in swallowing).
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Chest pain.
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Continuous heartburn.
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Pain in the upper abdomen.
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Stiffening of the esophagus.
Children:
How Dysphagia Occurs in Eosinophilic Esophagitis?
Eosinophilic esophagitis reduces the elasticity of the esophagus. Since many eosinophils are present, there is an inability of the esophagus to stretch and accommodate large quantities of swallowed food. As a result, scarring occurs on the lining wall of the esophagus. Meat and solid foods have difficulty passing through the esophagus. When hard food gets stuck in the esophagus, it results in an uncomfortable sensation in the chest. This difficulty in the food not freely entering the stomach is referred to as dysphagia.
If the solid food then reaches the stomach, after difficulty, then the discomfort usually subsides by itself. When there is no discomfort, the person can continue eating the food. When solid food has problems reaching the stomach, then it will feel better if one regurgitates the food. This might need to induce vomiting voluntarily. Only after that, can one continue eating.
Very rarely, solid food might get impacted in the esophagus. The food will get stuck in a way that it cannot be taken out or made to pass into the stomach. The food that is impacted can cause severe chest pain, which might resemble a heart attack. The patient might experience spitting up too much saliva, as it cannot be swallowed. Patients with impacted food feel difficulty in eating or drinking. The doctor might need the help of a flexible endoscope, which is inserted into the mouth to relieve the obstruction.
How Is It Diagnosed?
The diagnosis for eosinophilic esophagitis involves a variety of options.
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Upper Endoscopy: The doctor will use a long and thin tube called an endoscope. This tube contains a tiny camera and light, which is inserted into the mouth. It passes down the esophagus, and once it reaches the specified area, the doctor will ensure that the region is fully inspected along with the lining of your esophagus. Special attention is given for any swelling, inflammation, horizontal or vertical rings, furrowing, strictures (narrowing of the walls of the esophagus), and any reddish or white spots. There are cases where people having eosinophilic esophagitis might have an esophagus lining that looks normal.
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Biopsy Specimen: While performing an endoscopy, your doctor will perform a procedure called a biopsy, where a small tissue is removed from the esophagus. This biopsy specimen is sent for a lot of processes and then studied under a microscope. If there are too many eosinophils identified, then it can be a possible sign of eosinophilic esophagitis.
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Laboratory Blood Tests: If the doctor is suspecting eosinophilic esophagitis, you would be recommended to get some additional tests to confirm the diagnosis. The blood test will be checked for higher levels of eosinophil counts, and the total level of Immunoglobulin E will be detected. The main function of Immunoglobulin E is to enhance immunity. Any type of allergic reaction will be noted.
What Is the Treatment Protocol?
This condition is one where there are many chances of recurrence. So, the line of treatment will mostly rely on a continuous line of therapy.
Dietary Therapy:
Test for a few food allergies. Certain foods that are allergic to might cause symptoms such as diarrhea or vomiting. Such foods that are causing allergies should be stopped. The most common food allergens are dairy and wheat products. Eating a balanced diet will help. Completely avoiding the allergens can give relief from symptoms.
Medications:
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Proton-pump inhibitor (PPI): This medication is given to relieve the acid content in the stomach. This medication can be beneficial only for a few patients.
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Topical steroids: If the patient is not responding well to proton-pump inhibitors, topical steroids such as Fluticasone and Budesonide might be prescribed. Topical steroids will be in liquid or gel form, which is swallowed to treat eosinophilic esophagitis. There is a possibility of getting side effects such as irritation and dermatitis.
Home Remedies:
If one experience any of these symptoms, a few lifestyle changes may reduce the severity of symptoms:
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Maintain an Ideal Weight: Having an obese physique and having too much fat in the stomach can cause acid to build up in the stomach. This acid tends to back up into the esophagus. If your BMI is high, you should be focused on weight loss strategy. Add more fruits and vegetables to the diet.
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Avoid Foods, Drinks, and Beverages That Trigger Heartburn: The most common foods that trigger heartburn are fatty or fried foods, chocolates, sodas, tomato sauce, alcohol, mint, garlic chocolate, onion, and caffeine. Avoid foods that personally cause triggers to you.
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Elevate the Head in Bed: It is good to elevate the level of the head while sleeping, in case of regular heartburn.
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Relaxation Techniques: Perform mindfulness and relaxation techniques to relieve stress and anxiety. Too much stress has chances of inducing a mild degree of heartburn.
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Acupuncture: Acupuncture is a therapeutic method that involves penetrating needles into specific points in the body.
Conclusion:
Eosinophilic esophagitis (EoE) is a chronic immune-mediated condition characterized by inflammation of the esophagus. It is often triggered by allergic reactions to certain foods or environmental allergens. Symptoms can include difficulty swallowing, chest pain, and food impaction. Treatment usually involves dietary changes, medication, or in severe cases, dilation of the esophagus. Regular monitoring is crucial to manage the condition effectively and prevent complications.
