To understand eosinophilic esophagitis, one must first comprehend the meaning of two important terms: esophagus and eosinophils. The esophagus is the tube connecting the mouth to the stomach. Eosinophils are the white blood cells in the digestive system that defend the body against allergies and parasites. Eosinophilic esophagitis (also called EoE) results from an atypical immune response within the digestive tract, which increases the number of eosinophils in the esophagus’ inner lining.

Warning signs in adults

Difficulty swallowing (dysphagia)
Difficulty swallowing, or dysphagia, is a hallmark symptom of the condition. Patients, both children and adults, may feel like food is stuck in their esophagus, making swallowing uncomfortable and challenging. This symptom often leads to delayed or impaired passage of food through the esophagus.

Food impaction
Eosinophilic esophagitis can sometimes lead to food impaction. This symptom is characterized by difficulty and discomfort as food gets lodged in the esophagus after swallowing. Food impaction can result in fullness, chest discomfort, and the need for expert intervention to remove the impacted food.

Centrally located chest pain
Centrally located chest pain that does not respond to home remedies is another distinctive symptom in adults. This pain is usually intense and can be attributed to inflammation and structural changes in the esophagus. Immediate attention is essential when individuals encounter chest pain, particularly if the pain is accompanied by shortness of breath or pain in the jaw or arm. A combination of these symptoms may indicate a heart attack.

Regurgitation or reflux
Regurgitation, characterized by the backflow of undigested food, is another common symptom in adults. When the esophagus does not function properly, the food from the stomach travels upward into the esophagus. This causes discomfort and sometimes a sour taste in the mouth. Regurgitation usually does not improve, even with general treatments or home remedies.

Heartburn
Heartburn is more common in gastroesophageal reflux disease (GERD). However, some individuals with eosinophilic esophagitis may also experience a burning sensation in the chest.

Difficulty breathing or talking
Some patients may experience respiratory symptoms, such as breathing issues, coughing, or wheezing. These discomforts can be associated with the inflammation in the esophagus.

Warning signs in children

Difficulty feeding (in infants)
Infants with eosinophilic esophagitis may exhibit signs of discomfort or resistance during feeding. As a result, the process can become challenging for both the infant and the caregiver. Recognizing and addressing feeding difficulties is crucial to prevent the condition from worsening or leading to other health issues.

Difficulty eating
As children with eosinophilic esophagitis grow older, they continue to face difficulty with eating. Sometimes, the problem may even get worse. Kids may experience discomfort or pain while swallowing dense, dry, or solid foods, impacting their overall nutritional intake and quality of life.

Decreased appetite
Esophageal inflammation can lead to sensations of obstruction and pain while swallowing, contributing to a decreased appetite. The reluctance to eat may also result from the fear of triggering symptoms like dysphagia or food impaction.

Vomiting
Vomiting is a prevalent symptom in pediatric cases. Children with the condition may vomit in response to the challenges associated with swallowing and food impaction or the discomfort caused by inflammation in the esophagus. A healthcare expert should evaluate patients who experience persistent or recurrent vomiting.

Food aversion
Children with eosinophilic esophagitis may develop aversions to certain textures or types of food due to the challenges and discomfort associated with eating.

Abdominal pain
Abdominal pain is a common complaint among children with this health condition. The inflammation in the esophagus can lead to discomfort that extends to the abdominal region. Therefore, it is vital to identify and address abdominal pain early on.

No response to GERD treatment
Some children with eosinophilic esophagitis may not respond to the treatments used for managing GERD.

Stunted growth
In severe cases, the condition can contribute to stunted growth and malnutrition in children. Early diagnosis and intervention are crucial in such cases. An expert can address the underlying causes of the problem and implement effective strategies to promote growth and overall health in affected children.

What causes eosinophilic esophagitis?
Eosinophilic esophagitis is a chronic immune-mediated inflammatory condition. It can occur when the body has a severe allergic reaction. Genetic predisposition or environmental factors can also increase one’s risk. Other triggers include certain foods (with a notable association with allergic conditions), extreme cold or dry climate, and the presence of respiratory and allergic diseases like asthma, hay fever, eczema, or atopic dermatitis. Age or gender can also be notable risk factors, with males and adults being more susceptible. Those in the high-risk group should watch for the symptoms and follow the preventive measures recommended by an expert.

When to consult a healthcare professional?
Those who experience severe or recurring symptoms of eosinophilic esophagitis should schedule an appointment with a healthcare provider. If someone regularly uses treatments for heartburn (more than twice a week), they should consult a healthcare professional to assess and address any underlying concerns.

Diagnosing and managing eosinophilic esophagitis requires a multidisciplinary approach. It may involve undergoing tests like endoscopy and biopsy and collaboration with gastroenterologists, allergists, and nutritionists. Patients may also have to make food and lifestyle modifications and monitor the condition to alleviate its symptoms and prevent complications.