Eosinophilic Esophagitis

We offer a comprehensive eosinophilic esophagitis (EoE) clinic for adults, working in concert with your gastroenterologist.

EoE is a recently recognized allergic condition. A person with EoE will have inflammation or swelling of the esophagus. The esophagus is the tube that sends food from the mouth to the stomach.

In EoE, large numbers of white blood cells called eosinophils are found in the tissue of the esophagus. Normally there are no eosinophils in the esophagus. EoE can occur at any age.. The symptoms of EoE vary with age. In infants and toddlers, you may notice that they refuse their food or are not growing properly. School-age children often have recurring abdominal pain, trouble swallowing or vomiting. Teenagers and adults most often have difficulty swallowing. The esophagus can narrow to the point that food gets stuck. This is called food impaction and is a medical emergency.

Currently, the only way to make a diagnosis of EoE is by an endoscopy with biopsies of the esophageal lining. During an endoscopy, a gastroenterologist inserts a small tube with a camera located at the tip into the mouth, down the esophagus, and into the stomach and first part of the small intestine. The doctor will look at the tissue lining of the gastrointestinal tract and take small pieces of tissue called biopsies. During the endoscopy, the gastroenterologist will also look for any changes in the appearance of the esophagus, including white blotches, long white lines (called linear furrows) or rings. After the biopsies have been taken, a pathologist will look at the small samples of tissue under the microscope and count the number of eosinophils in a set area.

After a patient has been diagnosed with EoE, he or she will work with Dr. Jacobs and undergo extensive allergy testing. The testing will assist the team in figuring out possible food and/or environmental causes of the patient's EoE symptoms. This testing includes a complete history and physical, skin prick testing, and possible patch testing.  Maximizing control of environmental nasal allergies and asthma is also important.

Pinpointing what is causing EoE may be challenging. Because each person is different, so are the treatment options. EoE may be treated through food avoidance of offending allergens and/or through the use of medications.