Diagnosis and treatment of eosinophilic esophagitis

By: Ohio State Wexner Medical Center

Food allergies are a question that patients ask commonly. There are a number of considerations. So one important food allergy of course is gluten in patients who have celiac disease. And that really is essentially an allergy to gluten for those patients. There's another condition that we're seeing more often especially in our young male patients and that's called eosinophilic esophagitis. That's a condition where there' inflammation of the esophagus.

Patients may present with trouble swallowing, or just intermittent trouble swallowing or sometimes we see them because they swallowed something like a large piece of meat, end up in the emergency room and we need to go down with a scope and remove that. Eosinophilic esophagitis is diagnosed by endoscopy. Sometimes when we perform an endoscopy, pass a lighted tube down into the esophagus and evaluate the lining of the food pipe, we can see certain changes that are suggestive of an allergic esophagitis, eosinophilic esophagitis. And then of course the real gold standard is to take some small pinches of tissue during that procedure and look at those under the microscope and we see an increase in the number of allergic type cells called eosinophils and that's really the hallmark of eosinophilic esophagitis. Identifying trigger foods is can be a a challenge in our patients with eosinophilic esophagitis. But there are some foods that are more common in terms of creating problems or creating allergies.

Sometimes patients undergo specific allergy testing and at other times an elimination diet may be part of the diagnostic process. We have very effective ways to treat that with medication and also with dietary measures. We work very closely with our colleagues in allergy and immunology to really improve this condition. Patients are much better after we work with them with regard to diet and also to the right medications.

Diagnosis and treatment of eosinophilic esophagitis

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