What are the symptoms of eosinophilic oesophagitis?

Eosinophilic oesophagitis is a chronic inflammatory condition that affects the oesophagus (food pipe). This condition is characterised by white blood cells known as “eosinophils” being present in the lining of the oesophagus due to allergy or infection. Eosinophilic oesophagitis seems to be more common in people with allergic conditions such as food allergy, eczema, allergic rhinitis or asthma.

Leading London gastroenterologist Dr Aathavan Loganayagam explains the signs of eosinophilic oesophagitis in both adults and children and how it is treated.

What are the symptoms of eosinophilic oesophagitis?

The initial symptoms of eosinophilic oesophagitis may occur at any age. In young children, the condition should be considered if there are reflux-like symptoms (e.g. vomiting, regurgitation, abdominal discomfort) or persistent feeding problems.

In older children and adults, difficulty swallowing and food impaction in the oesophagus are the symptoms. Eosinophilic oesophagitis should also be considered in people with gastro-oesophageal reflux disease who are not responding well to treatment.
 

How is eosinophilic oesophagitis diagnosed?

The diagnostic criteria for eosinophilic oesophagitis are:

• Characteristic symptoms
• Endoscopy – there are several characteristic findings at gastroscopy which can suggest eosinophilic oesophagitis.
• A large number of eosinophils in oesophageal biopsies – these biopsies can be performed during a gastroscopy procedure. Oesophageal eosinophils may also be seen in gastro-oesophageal reflux disease.
• Specific blood tests – (e.g. eosinophil count, IgE level) may provide supportive evidence for the condition.
   

Finally, it is also important to exclude other conditions which may have symptoms similar to eosinophilic oesophagitis.
 

How is eosinophilic oesophagitis treated?

In the short term, the patient can experience relief with steroids, which are swallowed to coat the lining of the oesophagus. However, the mainstay of therapy is to identify a dietary cause for eosinophilic oesophagitis and to eliminate the offending food.

This is a complex process usually requiring the help of an expert dietitian. Common foods that cause eosinophilic oesophagitis include milk, egg, wheat, soy, peanuts/tree nuts, and seafood (fish/shellfish).
 

Can eosinophilic oesophagitis cause cancer?

There is no reported evidence of a link between eosinophilic oesophagitis and cancer.

Book an appointment with Dr Loganayagam if you are concerned that you are living with the condition.