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Eosinophilic Esophagitis

Medical Author: Dennis Lee, MD
Medical Editor: Jay W. Marks, MD

What is eosinophilic esophagitis?

Eosinophilic esophagitis is an inflammatory condition in which the wall of the esophagus becomes filled with large numbers of eosinophils.

The esophagus is the 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, though acid reflux also can cause ulcers on the inner lining of the esophagus. Other less common causes of esophagitis include viruses (such as herpes simplex), fungi (such as Candida), medications that get stuck in the esophagus (such as the antibiotic, tetracycline), and radiation (such as for treatment of lung cancer). Doctors believe that eosinophilic esophagitis is a type of esophagitis that is caused by allergy just like asthma, hay fever, allergic rhinitis, and atopic dermatitis even though the exact substance that is causing the allergy 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 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. The allergen(s) that causes eosinophilic esophagitis is not known. It is not even known whether the allergen is inhaled or ingested. Eosinophilic esophagitis is more common among individuals with other allergic conditions such as asthma, hay fever, allergic rhinitis, and atopic dermatitis.

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.



Next: What are eosinophilic esophagitis symptoms? »

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Eosinophilic Esophagitis

Swallowing problems overview

The swallowing tract extends from the mouth to the stomach. The act of swallowing normally occurs in three phases. In the first phase, food or liquid is contained in the mouth by the tongue and palate (oral cavity). This phase is the only one we can control.

The second phase of swallowing begins when the brain makes the decision to swallow. At this point, a complex series of reflexes begin. The food is thrust from the oral cavity into the throat (pharynx). At the same time, two other events occur: A muscular valve at the bottom of the pharynx opens, allowing food to enter the swallowing tube (esophagus), and other muscles close the airway (trachea) to prevent food from entering the airways. This second phase of swallowing takes less than half a second.

The third phase of swallowing begins when food enters the esophagus. The esophagus, which is about nine inches long, is a muscular tube that produces wav...

Read the Swallowing Problems article »










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