Esophagitis

Eosinophilic [ee-uh-sin-uh-FIL-ik] esophagitis [ih-SOF-uh-JAHY-tis], or EE, is an allergic reaction that causes inflammation (swelling) in the esophagus. The esophagus is the tube going from your mouth to your stomach. The inflammation can make the esophagus become more narrow and stiff. This can make swallowing difficult and cause food to get caught in your esophagus.

EE is becoming more commonly diagnosed in both children and adults. It’s a chronic condition, meaning it doesn’t go away completely.

If EE is not treated or your symptoms are not controlled well, you may have other health problems. These can include narrowed areas in your esophagus where food can get stuck. In rare cases, this can cause forceful vomiting. Also, repeated dilations may cause a tear of the esophagus, which would need medical attention right away.

The most common symptoms of EE are difficulty swallowing and pain when swallowing solid foods. Other symptoms include:

• Heartburn
• Vomiting (often during meals)
• Stomach pain
• Chest pain
• Nausea
• Weight loss

Contact your doctor if you have any of these symptoms:

• Difficulty or pain while swallowing that lasts more than a few days
• Difficulty or pain while swallowing, along with flu symptoms like headache, fever, and muscle aches

Get emergency care if you have:

• Chest pain that lasts more than a few minutes
• Food that is stuck in your esophagus that you can’t get out

People with EE have more eosinophils (a certain type of white blood cell) in their esophagus. The reason this happens isn’t exactly known. Most research suggests that it’s because of an allergic reaction to certain types of proteins found in some foods. Many people with EE also have a family history of other allergic reactions like asthma, runny nose, skin rash, or food allergies.

The only way to know for certain if your symptoms are caused by EE is to do an endoscopy. During endoscopy [en-DOS-kuh-pee] the doctor inserts a thin, flexible tube with a light (an endoscope) into the esophagus. This allows the doctor to see inside and to take tissue samples (biopsies). The tissue samples can be tested for eosinophils and other signs of EE.

EE treatment is focused on controlling symptoms and preventing other problems. Symptoms can be controlled, but may return from time to time. Your doctor may recommend one or more of these things:

• Diet changes. Your doctor may recommend you stop eating certain foods for a period of time. In some cases, this may mean stopping several foods, and then bringing one of them back at a time into your diet. This will help you know if that food is causing a problem. Foods to stop eating may include milk, soy, egg, wheat, nuts, or seafood.
• Medicine. Your doctor may recommend medicine to lower stomach acid and inflammation. This may be done to see if your symptoms are caused by another illness like GERD (gastroesophageal reflux disease).
• Visit an allergy doctor. Your doctor may recommend you visit a doctor who specializes in allergies. This doctor can help identify which foods you should stop eating.
• Stretching the esophagus. If other treatments have been tried and not worked well enough, your doctor may recommend inserting a balloon-like device to gently dilate (stretch) the esophagus. This can allow food to pass through more easily.

We don’t know the exact causes of esophagitis, however good tips to help reduce your risk include avoiding irritating foods and taking medications only as directed.