Eosinophilic Esophagitis

Medical Author:
Medical Editor:

Eosinophilic esophagitis facts

  • Eosinophilic esophagitis is an inflammatory condition of the esophagus that affects both children and adults, and men more than women.
  • Eosinophilic gastroenteritis may be due allergy to an as yet unknown food allergen.
  • The major symptom in adults with eosinophilic esophagitis is dysphagia (problems swallowing) for solid food.
  • Eosinophilic esophagitis stiffens the esophagus so that solid foods have difficulty passing through the esophagus and into the stomach.
  • Other common causes of dysphagia for solid food are esophageal strictures and Schatzki rings.
  • The diagnosis of eosinophilic esophagitis usually is made during an endoscopy (EGD), performed for the evaluation of dysphagia. The diagnosis is confirmed by biopsy of the esophagus.
  • The treatment of eosinophilic esophagitis is with proton pump inhibitors and swallowed fluticasone propionate. Gentle esophageal dilatation is used when meditations fail to relieve dysphagia.

What is and what causes eosinophilic esophagitis?

Eosinophilic esophagitis is an inflammatory condition in which the wall of the esophagus becomes filled with large numbers of eosinophils, a type of white blood cell.

The esophagus is a muscular tube that propels swallowed food from the mouth into the stomach. Esophagitis refers to inflammation of the esophagus that has several causes.

  • The most common cause of esophagitis is acid reflux, which most frequently results in heartburn. Acid reflux also can cause ulcers in the inner lining of the esophagus.
  • Other less common causes of esophagitis include viruses (such as herpes simplex), fungi (such as Candida), medications that become stuck in the esophagus (such as the antibiotic, tetracycline), and radiation therapy (such as during treatment of lung cancer).

Doctors believe that eosinophilic esophagitis is a type of esophagitis that is caused by an allergen for two reasons. First, eosinophils are prominent in other diseases associated with allergies such as asthma, hay fever, allergic rhinitis, and atopic dermatitis. Second, people with eosinophilic esophagitis are more likely to suffer from these other allergy diseases. Nevertheless, the exact substance that causes the allergic reaction in eosinophilic esophagitis is not known. The hallmark of eosinophilic esophagitis is the presence of large numbers of eosinophils in the tissue just beneath the inner lining of the esophagus.

Eosinophils are white blood cells (leukocytes) manufactured in the bone marrow and are one of the many types of cells that actively promote inflammation. They are particularly active in the type of inflammation caused by allergic reactions. Thus, large number of eosinophils can accumulate in tissues such as the esophagus, the stomach, the small intestine, and sometimes in the blood when individuals are exposed to an allergen. As previously mentioned, the allergen(s) that causes eosinophilic esophagitis is not known. It is not even known whether the allergen is inhaled or ingested.

Eosinophilic esophagitis affects both children and adults. For unknown reasons, men are more commonly affected than women, and it is most commonly found among young boys and men.

This article primarily deals with the diagnosis and management of swallowing problems (dysphagia), the most common complication in adults with eosinophilic esophagitis.

Medically Reviewed by a Doctor on 12/2/2013

Patient Comments

Viewers share their comments

Eosinophilic Esophagitis - Experience Question: Please describe your experience with eosinophilic esophagitis.
Eosinophilic Esophagitis - Symptoms and Signs Question: What symptoms and signs did you experience with eosinophilic esophagitis?
Eosinophilic Esophagitis - Treatment Question: What was the treatment for your case of eosinophilic esophagitis?
Eosinophilic Esophagitis - Diet Question: Did you try an elimination diet to treat eosinophilic esophagitis? Please share your story.
Eosinophilic Esophagitis - Diagnosis Question: Please describe the events that led to a diagnosis of eosinophilic esophagitis.