Eosinophilic Esophagitis

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Medical Author:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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Medical Editor:

Bhupinder Anand, MD

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 have several causes. The most common cause of esophagitis is acid reflux which most frequently results in heartburn, although 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 get 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 allergy for two reasons. First eosinophils are prominent in other diseases associated with allergy such as asthma, hay fever, allergic rhinitis, and atopic dermatitis. Second, patients with eosinophilic esophagitis are more likely to suffer from these other allergic diseases. Nevertheless, the exact substance that is causing 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. 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.