Eosinophilic Esophagitis (EoE)

Eosinophilic esophagitis (e-o-sin-o-FILL-ik uh-sof-uh-JIE-tis) is the inflammation of the lower segment of the esophagus (the tube that connects the pharynx with the stomach). EoE can be painful and often appear as stomach ache or symptoms that resemble GERD (heartburn, burping, vomiting). Sometimes, EoE appears as:

• Difficulty swallowing
• Impacted food
• Chest pain
• No response to GERD treatment

It can also be associated with underlying conditions such as allergies. Allergic symptoms can include:

• Chronic cough
• Chronic sinusitis
• Ear infections
• Poor weight gain in children
• Anemia

Eosinophilic esophagitis is characterized by infiltration by eosinophils, white blood cells which are often found in allergic conditions. In more than half of pediatric cases of EoE, allergies are the major cause. When allergies are identified, treating them may dramatically improve or even resolve EoE. For this reason, we do skin and laboratory tests to identify environmental as well as food allergies in patients with EoE. Common trigger foods may include milk, wheat, and corn, but other foods may also contribute to EoE.

Detailed blood (IgE and IgG specific antibodies) and skin testing, and select food trials give us the information to create a personalized food allergy profile. We use this profile to:

• Develop a logical and feasible diet plan
• Reduce stress about food restrictions
• Reduce need for endoscopies/biopsies

Allergy drop immunotherapy, along with diet changes and medication, can help manage eosinophilic esophagitis. Sublingual immunotherapy for environmental and food allergy to address EoE is especially suited for children because it’s safe and easy to take. Eosinophilic esophagitis often associated with conditions such as asthma, nasal polyps and chronic sinusitis, which can be avoided with early diagnosis and allergy drop immunotherapy. Allergy drop treatment following the La Crosse Method Protocol has not been shown to trigger EoE in patients, so can be used safely for those who’ve been diagnosed with this condition.