When you think of allergic reactions, you probably envision itchy eyes and a runny nose. But an allergic reaction can occur in the esophagus – your food pipe – as well. Symptoms happen when your immune system produces too many white blood cells in reaction to an allergy-causing substance. The white blood cells involved are called eosinophils.
The condition is called eosinophilic esophagitis, or EE or EoE. It affects between one and four of every 10,000 people in the U.S.
Symptoms of EoE vary from person to person and may include:
Acid reflux that doesn’t respond well to medication
Trouble eating and swallowing food
Food getting stuck in the throat
Having to drink a lot of fluid to finish a meal
Feeling too full to continue eating halfway through a meal
Stunted growth or poor weight gain in children
Who’s at risk
The disease affects both children and adults, but is more common in men. People with asthma and food or environmental allergies have a much greater chance of developing it.
Your doctor will take your medical history and will likely want to test you for allergies. He or she will probably do an endoscopy. This is an outpatient procedure that involves passing a thin, flexible scope with a camera through your mouth to look at your esophagus. The doctor will check for physical signs of inflammation and an increased number of eosinophils. To confirm the diagnosis, your health provider will likely need to take a biopsy, or tissue sample, from your esophagus.
For treatment, you will need to work closely with an allergist and a gastroenterologist, a specialist in digestive disorders. They’ll help you figure out what substances or foods to avoid. No specific medications can cure EoE, although certain steroids may help to reduce the swelling in your esophagus.
You can best manage EoE by learning what substances cause your allergic reaction and avoiding them. In many cases, the allergens come from food. With your medical team, you can develop an action plan to change your diet accordingly.
It’s also important to know that the reactions related to EoE might take days or weeks to develop. Keep this in mind when beginning a food elimination plan. It might take some time after avoiding a particular food to determine whether that strategy worked.
When to call the doctor
Call your doctor if you have EoE and notice any of these symptoms: