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Eosinophilic Esophagitis

Eosinophilic esophagitis (EoE) is a newly recognized chronic disease that can be associated with food allergies. It is increasingly being diagnosed in children and adults. EoE is characterized by inflammation and accumulation of a specific type of immune cell, called an eosinophil, in the esophagus.

Symptoms of EoE include nausea, vomiting, and abdominal pain after eating. A person may also have symptoms that resemble acid reflux from the stomach. In older children and adults, it can cause more severe symptoms, such as difficulty swallowing solid food or solid food sticking in the esophagus.  In infants, this disease may be associated with failure to thrive.
EoE patients have inflammation and high numbers of Eosinophils in the esophagus ( food pipe ).  Eosinophils and inflammation disrupts the normal functioning of the food pipe, resulting into the symptoms.  People with EoE generally are allergic to various foods.  They test positive for food allergies on skin test or blood test. These patients may not have the typical food allergy symptoms such as skin rashes, itching or anaphylactic reactions.  Patients improve when they avoind culprit foods and get worse when they eat them again. Most common foods that cause this are milk, soy, eggs, wheat, peanut, shelfish and fish. and tree nuts.  Although other foods may be involved.
This condition is diagnosed via upper GI endoscopy in which under sedation, a fiber optic scope is placed in the esophagus and biopsy samples are taken. 
Teatment involves avoiding fodos taht an individual is allergic to.  Swallowing 'inhaled corticosteroids" is an off label use of steroid inhalers.  This may not be as effective as avoiding the foods an individual is allergic to.  Leukotriene blockers, such as Montelukast in conjunction with antihistamines may  have some beneficial role in treating this condition.
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