What is EoE?

EoE (eosinophilic oesophagitis) is a rare chronic inflammatory condition affecting the oesophagus (also known as the gullet or food pipe). Its origins and causes are not yet fully understood. However, it appears that an ongoing allergic response to food or an environmental factor leads to this inflammation. The inflammation is identified by the presence of substances released by specialised white blood cells which are not normally found in the lining of the oesophagus (the mucosa). These cells are called eosinophils and give EoE its name. The ‘-itis’ at the end of the word oesophagitis means ‘inflamed’. When this inflammation is uncontrolled, it can lead to adverse changes in the oesophagus. These include narrowing and loss of function of the oesophagus, which can affect the ability to swallow food and can lead to associated symptoms that may affect the quality of life of people with EoE. Read more…

What are the symptoms of EoE?

The main symptom in adults is difficulty swallowing (dysphagia). It sometimes feels as if food is stuck in your throat while you are trying to swallow. Pain when swallowing (odynophagia) can also occur. Other possible symptoms include discomfort in the chest and, less often, in the lower part of the throat or the upper abdomen. In the worst-case scenario, EoE can lead to a piece of food becoming stuck in your oesophagus and causing an obstruction. This is known as food bolus impaction. Read more…

You should seek medical advice if you have experienced the symptoms described above for some time or have noticed them in a family member.

What are the symptoms of EoE?

The main symptom of EoE in adults is difficulty swallowing, also known as ‘dysphagia’. It feels as if food is stuck in your throat. Additionally, pain when swallowing (‘odynophagia’) can occur. Other possible symptoms include discomfort in the chest and, less often, in the lower part of the throat or the upper abdomen. In the worst-case scenario, EoE can lead to a piece of food actually getting stuck and cause an obstruction of the oesophagus. This is called food bolus impaction. Read more…

You should seek medical advice if you or a family member has experienced the symptoms described above for some time.

HOW IS EoE TREATED?

There are currently four different treatment options for EoE – locally acting (topical) steroids, proton pump inhibitors (PPIs), diet and dilation. The doctor will normally discuss these options with you so you can decide together whether locally acting steroids, PPIs or diet is best for you. How steroids and PPIs work is not completely clear, however, both appear to reduce the inflammation and the associated tissue damage in the oesophagus which cause the symptoms.

A dietary approach is different. It focuses on eliminating a certain food or foods that cause an allergic reaction and subsequent inflammation and tissue damage in the oesophagus. In some people, environmental factors may also cause an allergic response, possibly independent of food, so the dietary approach may not be effective for them. These foods or environmental factors are called allergens.

If someone with EoE experiences significant ongoing symptoms while receiving one of these three treatments, their doctor might decide that they should undergo an endoscopic-based procedure known as a dilation. Dilation stretches and widens the oesophagus, normally giving you immediate symptomatic relief. However, this procedure doesn’t have an effect on the underlying disease process in the oesophagus so you may need ongoing treatment with locally acting steroids, PPIs or diet. Read more…

Impact of EoE on your quality of life
A chronic condition such as EoE can bring emotional distress due to the symptoms you may be experiencing and the way you handle them, successfully or otherwise. You may also be worried about getting food stuck in your oesophagus and having to be taken to the emergency department to have it removed. These concerns may change your behaviour – eating slowly, avoiding certain foods and drinking large quantities of water and/or using excessive amounts of sauce to ‘lubricate’ your food before swallowing it .
Your concern about being embarrassed about any of these issues may lead you to avoid social situations where food is involved, and this can be very isolating. Learning about the condition and getting the right treatment is therefore very important in helping you to enjoy normal social activities and improve your overall quality of life.