Food Allergies & Eosinophilic Esophagitis (EE)

A few months back, I discussed the interesting growth of food-related illnesses and diseases.  Eosinophilic Esophagitis (EE) is another disease that is growing in recognition among the medical community because of the increase in the number of cases.  One tough aspect of this disease, I have heard/read, is that it is often not just one food that is the culprit, but multiple foods (and not just 3).  Many cases of EE wind up with a long list of foods to be avoided.  EE affects both children and adults, but seems to show up more in young boys and men.

What is Eosinophilic Esophagitis?

Eosinophilic Esophagitis (EE) affects the esophagus by building up a type of white blood cell along the tube that runs food from your mouth to your stomach (the esophagus).  The build up of the white blood cells, if left untreated, can cause significant damage and change to the structure and function of the esophagus.

Symptoms of EE

  • Difficult and painful swallowing
  • Chest pain that occurs with eating
  • Food impaction in the esophagus
  • Nausea
  • Vomiting
  • Abdominal pain
  • Cough
  • Decreased appetite
  • Weight loss

Causes of EE

There are different types of esophigitis (reflux, drug-induced, infectious), but eosinophilic esophigitis is directly related to an allergic reaction to food.  The white blood cells mentioned above, called eosinophils, help regulate inflammation and play a role in allergic reactions.  Too many of these white blood cells in the esophagus, in response to an allergen, is what causes EE.  Also stated above, people with EE are allergic to one or more foods, and often a number of environmental allergens as well.  The most common foods that are associated with EE are:

  • milk
  • eggs
  • wheat
  • soy
  • peanuts
  • beans
  • rye
  • beef

The risk of developing EE is not any different from food allergies (and of course, researchers are still trying to pinpoint the root cause), in that family history of EE or allergies puts you at increased risk of developing the disease.

If EE goes untreated, as stated above, the structure and function of the esophagus can be drastically changed.  The esophagus can narrow, rings of abnormal tissue can develop, and other conditions that can lead to esophageal cancer.

A number of tests can be performed to come up with an EE diagnosis, including Barium X-Ray, Endoscopy, Tissue Lab Tests, and Allergy Tests.  Another test that is sometimes performed because of difficulty pinpointing the underlying food allergens is an elemental liquid diet.  This diet requires the individual to drink a liquid of digested food that no longer contains allergy-provoking proteins.  Slowly foods are introduced back into the diet to find out what foods are acceptable and what foods trigger the reactions.  (There was child who used to be in my daughter’s class that had to do this and it was very scary and sad for the family.  The mother was constantly in fear of hurting her son.  But you would never have known the child had any problems because they were all so positive about life.  Thankfully, the world opened up to him when he was finally able to have wheat, egg and soy at the age of 7 or 8.)

Treatment for EE

Like food allergies, EE is best controlled by avoidance of all allergenic foods.  In fact, avoidance of allergic foods can resolve all EE symptoms and heal damage to the esophagus.  If a restricted food is eaten, medications for controlling the reaction can be taken.  Medications include oral steroids, inhaled steroids, and acid reflux medication.  Another treatment is a procedure to expand the esophagus in severe cases.

Do you or your child suffer from EE? Can you share your experience with us?

References: Mayo Clinic, Eosinophilic Esophagitis Home,

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