Eosinophilic esophagitis (NORD)

Eosinophilic esophagitis or eoe is a chronic food allergy associated digestive disorder in which people have large numbers of eosinophils in the esophagus, eosinophils are a type of white blood cell that play many roles within the immune system and are involved in allergic reactions.

Signs and symptoms of eosinophilic esophagitis can vary quite a bit and are frequently the same as those for gastroesophageal reflux disease.

Also known as GERD. These symptoms are caused by increased inflammation and swelling within the esophagus and include trouble swallowing, food, getting stuck in the throat, nausea, vomiting, poor growth in childhood weight loss, stomach pain, poor appetite and malnutrition.

The increase in eosinophils in the esophagus can be caused by a number of things, particularly hypersensitivity reactions or changes to the expression of certain genes.

The hypersensitivity reactions involved are a form of allergic reaction after exposure to a food or environmental allergen.

When certain cells come in contact with the allergen, they signal other cells most commonly eosinophils to accumulate and get activated in the esophagus.

The first exposure to an allergen may take time to create a response. However, some cells remember that allergen to more quickly react to future exposures.

Therefore, the more a person is exposed to allergens which trigger a hypersensitivity reaction. The more eosinophils will be present.

Additionally, changes to gene expression appear to play a role in increasing the number of eosinophils. In a person with eoe, a primary gene involved in people with EOE is C 26 which encodes for eotaxin.

Three. Eotaxin three is a protein that triggers increased eosinophil production and the gene is often overexpressed, meaning it is used to make more proteins than usual in people with eosinophilic esophagitis.

When eotaxin three makes more proteins, those proteins trigger more eosinophils to be recruited to the esophagus. Consequently, resulting in the increased number of eosinophils present in people with eoe some other genes that are associated with eoe such as CN 14 contribute to the loss of esophageal barrier function, allowing increased ability for allergens and inflammatory cells like eosinophils to enter the esophagus leading to the development of eosinophilic esophagitis.

Genetic factors are important in eoe as demonstrated by twin studies which show a high rate of eoe in both twins, but this is not 100%.

And environmental factors, especially early life exposures play a role in developing eosinophilic esophagitis. Eoe is typically not passed on within families and the risk for family members of a person with eoe to develop eoe is less than 5% unless there is an affected twin.

Eosinophilic esophagitis is diagnosed based upon endoscopic evaluation in a patient with clinical symptoms during the upper endoscopy, a procedure in which a small flexible tube with a camera is placed down a person's throat to take pictures and remove tissue samples of the upper gastrointestinal tract and esophagus.

The number of eosinophils in the esophagus are quantified by a pathologist. If the level is at least 15 eosinophils per high powered microscopic field, then eoe is diagnosed, testing can also be done to determine if there is altered expression of genes such as CL 26 that play a role in eosinophilic esophagitis.

Eosinophilic esophagitis can usually be treated by taking a proton pump inhibitor pill to decrease inflammation in the esophagus as well as avoiding common food allergens such as milk, soy, eggs, wheat, nuts and fish.

If symptoms continue after initial treatments, more intensive treatments may be required. These other treatments include prescription steroids to further reduce inflammation and inserting a feeding tube to provide all meals in a liquid form directly into the stomach to avoid the esophagus coming in contact with any potential allergens.

A number of biological agents, especially those that directly target eosinophils or allergic hypersensitivity are now being developed for the treatment of eosinophilic esophagitis.

Eosinophilic esophagitis is a chronic digestive disorder in which there is an increased number of eosinophils in the esophagus.

The signs and symptoms often resemble GERD and can vary from difficulty swallowing to failure to thrive in Children. The increased eosinophils are typically caused by allergic immune hypersensitivity to food allergens and altered expression of certain genes.

After a clinical evaluation diagnosis is established by an upper endoscopy and related biopsies. Most people can be treated with proton pump inhibitors, dietary treatment or topical glucocorticoids or