Eosinophilic esophagitis is a rare chronic disease. It causes pain in the chest and abdomen, difficulty swallowing and heartburn. For a long time, doctors considered eosinophilic esophagitis to be a childhood disease, but it turns out that more and more adults are affected by it. This is undoubtedly due to the fact that doctors are more aware of this disease, as well as an increased prevalence of allergies and asthma.
1. Eosinophilic esophagitis: definition of this inflammatory disease of the esophagus
The article Eosinophilic Esophagitis, published by the National Library of Medicine, precisely defines this rare chronic disease. The authors point out that eosinophils are white blood cells, which therefore belong to the immune system and whose function is to fight infections. In a person who does not have eosinophilic esophagitis, the esophagus does not have eosinophils, which are not naturally present in this part of the digestive system. Doctors have long thought that the presence of eosinophils in the esophagus was a clinical sign of gastroesophageal reflux disease (GERD). It has been established, through discoveries about the functioning of the esophagus, that GERD and eosinophilic esophagitis are two distinct pathologies. Eosinophils proliferate in the esophagus in response to an allergy. According to the French Association for Continuing Medical Education in Hepato-Gastroenterology, 1 to 5 people in 10,000 are affected by this disease.
2. Eosinophilic esophagitis: what are the symptoms of this inflammatory disease of the esophagus?
The French Association for Continuing Medical Education in Hepato-Gastroenterology indicates that the most common symptom of this disease is difficulty swallowing (called dysphagia by doctors) or eating. Other symptoms differ depending on whether the patient is a child or an adult. Children with eosinophilic esophagitis experience, in addition to dysphagia, weight loss, recurrent vomiting, and failure to thrive. In adults, other symptoms occur, including an inability to eat due to food blocking the esophagus, heartburn (pyrosis), chest pain and/or abdomen, food regurgitation. Eosinophilic esophagitis becomes a medical emergency when food gets stuck in your esophagus or when vomiting food causes your esophagus to tear. This is rare, but requires emergency treatment immediately. This condition is primarily associated with people with environmental or food allergies, asthma, eczema, and celiac disease.
3. Eosinophilic esophagitis: what are the treatments for this inflammatory disease of the esophagus?
The French Association for Continuing Medical Education in Hepato-Gastroenterology indicates the treatment methods implemented to relieve the symptoms caused by this disease:
- Drug treatment: prescription of antacid drugs, called proton pump inhibitors, and steroids, to reduce inflammation and destroy eosinophils. This treatment must be taken over a very long period in order to prevent the reappearance of the inflammation.
- Modification of diet to avoid allergenic foods: food allergies could be one of the triggers of eosinophilic esophagitis. To determine which allergen is at fault, doctors may recommend a targeted dietary approach. It consists of eliminating potentially allergenic foods one by one, by carrying out allergy tests. However, traditional allergy tests (skin tests or blood tests) have difficulty detecting the foods causing eosinophilic esophagitis. The avoidance strategy is often favored: it involves eliminating from the diet all potentially allergenic foods (milk, eggs, nuts, beef, wheat, fish, shellfish, soya, etc.), then reintroducing them one by one, which allows you to discover which food is the allergen. During the process, it is necessary to perform biopsies and endoscopies to assess the condition of the esophagus.
- Dilatation of the esophagus: this method of treatment is reserved for people with food stuck in the esophagus. This procedure is performed during an endoscopy.
Sources
- Eosinophilic Esophagitis, National Library of Medicine, August 8, 2023
- Eosinophilic esophagitis, French Association for Continuing Medical Education in Hepato-Gastroenterology, 2016
- Eosinophilic esophagitis: from pathology to treatment, French Association for Continuing Medical Education in Hepato-Gastroenterology, 2023
- Eosinophilic Esophagitis, Dr. Kristle Lee Lynch, The MSD Manual – Healthcare Professional Version, March 2022