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Eosinophilic esophagitis (EoE)

Eosinophilic esophagitis (EoE) is a chronic immune-mediated inflammatory condition that affects the esophagus, the muscular tube connecting the throat to the stomach. In EoE, the esophagus becomes infiltrated with a type of white blood cell called eosinophils, which are not normally found in this part of the digestive tract. This immune response leads to inflammation.

Key points:

  • Symptoms: May include difficulty swallowing (dysphagia), food impaction (getting food stuck in the esophagus), chest pain, heartburn, regurgitation, and food-related discomfort.

  • Triggers: EoE is often triggered by allergic reactions to specific foods, such as milk, eggs, wheat, soy, and nuts. The immune system's response to these allergens results in inflammation and the accumulation of eosinophils in the esophagus.

  • Diagnosis: The diagnosis of EoE typically involves an upper endoscopy and biopsy. During an endoscopy, a thin, flexible tube with a camera is inserted through the mouth and into the esophagus to visualize the tissue. Biopsy samples are taken to assess the presence of eosinophils in the esophageal lining.

  • Treatment: May include dietary modifications, where specific allergenic foods are eliminated from the diet, or medications such as proton pump inhibitors (PPIs), swallowed topical corticosteroids, and biologics that target specific immune pathways.

  • Complications: If left untreated, EoE can lead to esophageal strictures or narrowing, which can cause further difficulties with swallowing. In severe cases, chronic inflammation can result in damage to the esophagus.