Eosinophilic Esophagitis

Eosinophilic esophagitis is a non-infectious eosinophilic inflammation of the esophagus. The eosinophils belong among white blood cells and have a close relationship to allergic reactions and parasitic infections.

Causes

The cause of eosinophilic esophagitis is not clearly understood. The process leads to inflammation of the lining of the esophagus as its mucosa is packed with accumulated eosinophils. Perhaps this happens because of a food allergy, but the exact patophysiological mechanism is still under investigation. It was found, however, that a substantial part of the affected individuals have some form of allergies including asthma.

Symptoms

The disease manifests with swallowing disorders and sometimes the person can suffer from heartburn. The symptoms usually occur in children and young adults. When such problems occur in older people, we always have to have suspicion of esophageal cancer.

Diagnosis

Swallowing troubles should be always examined. It is possible to perform a radiological examination of the swallowing act (barium swallow). The person ingests a liquid contrast agent and the radiologist makes a series of X-rays to see the passage of the substance through the upper digestive tract. The second option is to perform the upper GI endoscopy. It allows us to see the inside of the esophagus and take biopsy sample from any suspicious-looking lesion. In eosinophilic esophagitis, the doctor finds the mucosa rugged with many circular rings. Only the biopsy confirms the diagnosis as histological examination shows a large number of eosinophils in the mucous membrane.

Treatment

The disease is still not fully understood and therefore there is no curative solution. It is recommended to perform an examination by an allergologist and to avoid potential allergens in the diet. Severe cases accompanied by stronger symptoms may be treated with anti-inflammatory drugs such as corticosteroids. When the esophagus is narrowed by the disease, the gastroenterologist can dilate this narrowing by inflation of a special balloon inserted by endoscopic device (therapeutic upper GI endoscopy).