Eosinophilic Esophagitis/Eosinophilic gastroenteritis

Overview

Eosinophilic Esophagitis (EoE) is an immune system condition of chronic esophagus inflammation, marked by an abnormal presence of eosinophils (white blood cells) in the lining of the esophagus. It can be triggered by certain foods or airborne allergens. Though sometimes confused with GERD, it is not caused by acid reflux and does not respond to acid-neutralizing therapies. Though the exact cause is unknown, the growing evidence of eosinophils playing a role in autoimmune diseases and the classification of EoE being an immunological tolerance disorder of the GI tract has led experts to think EoE may be an autoimmune disease.

Common Symptoms

Difficulty eating and swallowing, decreased appetite, vomiting, chest pain, failure to grow (in children). In some cases narrowing of the esophagus can lead to food getting stuck in the throat (food impaction).

Coexisting Diseases and Conditions

Celiac disease, Eosinophilic gastritis, enteritis, colitis, food, skin, and/or respiratory allergies, asthma, allergic rhinitis, atopic dermatitis.

Risk Factors and Prevalence

Most patients with EoE have a history of respiratory, food, or skin allergies. 

Eosinophilic esophagitis is most common in young men, but is seen in all ages and sexes. There is a strong genetic risk factor. Most people with Eosinophilic Esophagitis have an overexpressed eotaxin-3 gene, though CAPN14 and TSLP genes are also thought to be involved. Caucasian and non-hispanic white men are at higher risk.

Recent Research

First hand account

Read ‘The Mystery of My Burning Esophagus‘ in the New York Times Magazine.

Sources

  1. Article Sources

    1. Anderson, J., Moonie, S., Hogan, M. B., Scherr, R., & Allenback, G. (2020). Eosinophilic esophagitis: comorbidities and atopic disease in Nevada. Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus, 33(5), doz105. 

    2. Eosinophilic esophagitis. American Academy of Allergy Asthma & Immunology.

    3. Eosinophilic esophagitis – symptoms, causes, treatment: Nord. National Organization for Rare Disorders.

    4. Rothenberg, M. E. (2009). Biology and treatment of eosinophilic esophagitis. Gastroenterology, 137(4), 1238-1249.

    5. Roussel, J. M., &; Sudha Pandit, S. (2022, August 8). Eosinophilic Esophagitis. National Library of Medicine.

    6. Diny, N. L., Rose, N. R., & Čiháková, D. (2017). Eosinophils in Autoimmune Diseases. Frontiers in immunology, 8, 484. 

    7. Malhotra, N., & Levine, J. (2014). Eosinophilic esophagitis: an autoimmune esophageal disorder. Current problems in pediatric and adolescent health care, 44(11), 335–340.