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.
What are the symptoms of eosinophilic esophagitis?
The major symptom in adults with eosinophilic esophagitis is difficulty
in swallowing solid food (dysphagia). Specifically, the food gets stuck in the
esophagus after it is swallowed. Less common symptoms include heartburn and
chest pain. In children, the most common symptoms are abdominal pain, nausea, vomiting
, coughing, and failure to thrive.
How does eosinophilic esophagitis cause dysphagia?
Eosinophilic esophagitis decreases the ability of
the esophagus to stretch and accommodate mouthfuls of swallowed food probably as
a result of the presence of so many eosinophils but also, perhaps as a
result of some scaring that occurs in the wall of the esophagus. As a
result, solid foods (particularly solid meats) have
difficulty passing through the esophagus. When solid food sticks in the
esophagus, it causes an uncomfortable sensation in the chest, The sticking of
food in the esophagus is referred to as
dysphagia. If the solid food then passes into the stomach, the discomfort
subsides, and the individual can resume eating. If the solid food does not pass
into the stomach, individuals often must regurgitate the food by inducing
vomiting before they can resume eating. Rarely, the solid food becomes impacted,
that is, it can neither pass into the stomach nor be regurgitated. The impacted
solid food causes chest pain that can mimic a heart attack, and repeated spitting
up of saliva that cannot be swallowed because of the obstruction in the esophagus. Individuals with
impacted food are unable to eat or drink. To relieve the obstruction, a doctor
usually will have to insert a flexible endoscope through the mouth and into the
esophagus to remove the impacted food.
How eosinophilic esophagitis causes symptoms of abdominal
pain, vomiting, and
failure to thrive in children is not clear.
GERD (gastroesophageal reflux disease) is a condition in which the acidified liquid
contents of the stomach backs up into the esophagus. The symptoms of uncomplicated GERD are heartburn,
regurgitation, and nausea. Effective treatment is available for most patients with GERD.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Dysphagia or difficulty in swallowing, swallowing problems. Dysphagia is due to problems in nerve or muscle control. It is common, for example, after a stroke. Dysphagia compromises nutrition and hydration and may lead to aspiration pneumonia and dehydration.
Esophagitis is caused by an infection or irritation of the esophagus. Infections that cause esophagitis include candida yeast infection of the esophagus as well as herpes.
Barrett's esophagus occurs as a complication of chronic gastroesophageal reflux disease (GERD), primarily in white males. GERD refers to the reflux of acidic fluid from the stomach into the esophagus (the swallowing tube), and is classically associated with heartburn.
Achalasia is a disease of the esophagus that mainly affects young adults. Abnormal function of nerves and muscles of the esophagus causes difficulty swallowing and sometimes chest pain.
Gangrene may result when blood flow to a tissue is lost or not adequate to keep the tissue alive. There are two types of gangrene: wet and dry. All cases of wet gangrene are infected by bacteria. Most cases of dry gangrene are not infected. If wet gangrene goes untreated, the patient may die of sepsis and die within hours or days. Dry gangrene usually doesn't cause the patient to die. Symptoms of dry gangrene include numbness, discoloration, and mummification of the affected tissue. Wet gangrene symptoms include swelling, pain, pus, bad smell, and black appearance of the affected tissue. Treatment depends upon the type of gangrene and how much tissue is compromised by the gangrene.
Schatzki (Schatzki's) ring, is a narrow ring of tissue located just above the junction of the esophagus and stomach. The cause of Schatzki ring is not clearly known, however, some doctors believe they are caused by long term acid reflux. The symptoms of a Schatzki ring is primarily poorly chewed food that stays in chunks becoming stuck in the esophagus. Diagnosis of Schatzki's ring is barium x-ray or endoscopy. Treatment is generally a procedure to stretch or fracture the rings.
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