Eosinophilic oesophagitis (EoE)
Eosinophilic oesophagitis (EoE) is an increasingly common allergic condition of the oesophagus.
EoE often affects those with a history of asthma, hayfever or other allergies. In EoE, there is an allergic reaction to food/s that the patient is consuming. Over time, this can lead to inflammation and scarring in the oesophagus.
Symptoms include difficulty swallowing, food getting stuck in the chest, heartburn and chest pain. An endoscopy is required to diagnose the condition.
Effective treatments for EoE are available, and therapy involves reduction of inflammation (through medication or diet) along with endoscopic dilatation if any scar tissue (stricture) has already developed.
Therapeutic options to control inflammation include:
Proton pump inhibitors (PPIs): Medications such as Somac, Nexium, Pariet and others when taken at high doses can be effective in reducing inflammation in EoE. These medicines are also used in the treatment of acid reflux, and so are a good option for patients who have both conditions
Swallowed steroids: Asthma medications (Flixotide or Pulmicort) when swallowed rather than inhaled are highly effective in treating inflammation in EoE. They coat the inner lining of the oesophagus and act locally. Very little of the medicine is absorbed into the rest of the body, minimising the risk of side effects.
Diet: The six most common food groups triggering the allergic reaction of EoE have been identified as gluten, animal milk, egg, nuts, soy and seafood. A process of dietary elimination and reintroduction of some or all of these food groups is successful in curing the condition in many patients. This process needs to be embarked on under the guidance of an experienced gastroenterologist and dietitian, but offers the possibility of sustained medication-free remission.