Eosinophilic Oesophagitis (EoE)

Eosinophilic oesophagitis (EoE) is a disease of the oesophagus.  Oesophagitis is inflammation of the lining of the oesophagus (gullet).  The symptoms of inflammation are the body’s natural response to injury or irritation.

The main cells involved in the inflammation in EoE are eosinophils, which are a type of white blood cell.  Eosinophils play an important role in the body’s response to infection.  They are also involved in inflammation that occurs in allergic disorders.

Normally, eosinophils are present in very low levels in the body, but in EoE, large numbers are found in the tissue of the oesophagus.

The cause of EoE is not yet completely understood. It can be triggered by eating certain foods, most commonly (but not exclusively), milk, wheat, nuts, soya, fish and eggs.

EoE is often found in people with a family history of allergic conditions such as asthma or eczema and rhinitis.

The symptoms of EoE can vary from one person to another, and depend on age. 

• Dysphagia – difficulty swallowing / food sticking or food bolus.
• Excessive chewing.
• Eating Slowly.
• Food avoidance, such as meat and bread, preferring softer and/or wetter food.
• Drinking a lot during a meal.

Symptoms of EoE can become so severe that it may prevent sufferers from normal social eating and cause anxiety particularly when eating out in a restaurant.

Currently there is no known cure. There are various treatment options to help reduce the symptoms of EoE and make living with the condition easier.  Addressing the inflammation in EoE is important because if left untreated it can lead to a narrowing of the gullet.  There are 3 categories of treatment that can help reduce the symptoms of EoE:

1. Diet
2. Drugs
3. Dilation

Diet:

Avoiding trigger foods.  To find which foods are a trigger you may be asked to eliminate many suspect foods, then slowly reintroduce one by one once symptoms have settled, to try to see which foods trigger symptoms.

Steroids:

These are used to reduce the activity of eosinophils in the oesophagus and ease the inflammation. These are the most effective medications to reduce the symptoms quickly in the majority of patients.

Proton pump inhibitors:

These drugs are often used for acid-related diseases (of which EoE is not one), but also may help in EoE.

Dilatation:

Some people can experience severe narrowing of the oesophagus called ‘strictures’.  If this happens, your doctor may recommend dilatation to help making swallowing easier.

Further Information:

https://gutscharity.org.uk/