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Eosinophilic Esophagitis

Eosinophilic Esophagitis

In esophagitis (inflammation of the esophagus), immune cells (white blood cells) accumulate in the lining of the esophagus. Eosinophilic esophagitis is a chronic inflammatory esophagitis where eosinophils (a certain kind of white blood cells) can accumulate in large numbers in the lining of the esophagus. The process affects the normal function of the esophagus. The eosinophils are normally activated in allergic immune responses, therefore the theory is that eosinophilic esophagitis is a form of food allergy.

Causes

The triggers of the allergic-like inflammatory response in eosinophilic esophagitis are not known or understood. Food allergens and even airborne allergens are implied as possible triggers.
Newly found awareness about eosinophilic esophagitis in patients with dysphagia has recently increased the reported incidence of this condition.

Symptoms

The most common symptoms of eosinophilic esophagitis are dysphagia (difficulty swallowing) mostly with solid food.
The dysphagia is in part due to the inability of the esophagus to accommodate the food due to the chronic inflammation that stiffens the esophagus. Other symptoms may include heartburn and chest pain, but these are less frequent. In advanced disease, the food can get impacted in the esophagus, requiring endoscopic treatment and removal of the food blockage.

By Michel Kafrouni, M.D.

References 

1. Furuta GT, Liacouras CA, Collins MH, Gupta SK, Justinich C, Putnam PE, Bonis P, Hassall E, Straumann A, Rothenberg ME; First International Gastrointestinal Eosinophil Research Symposium (FIGERS) Subcommittees. Eosinophilic esophagitis in children and adults: a systematic review and consensus recommendations for diagnosis and treatment. Gastroenterology. 2007 Oct;133(4):1342-63. Epub 2007 Aug 8.
2. Moawad FJ, Veerappan GR, Wong RK. Eosinophilic esophagitis. Dig Dis Sci. 2009 Sep;54(9):1818-28. Epub 2009 Jun 25