What is Eosinophilic Esophagitis (EoE)?
Eosinophilic (ee-uh-sin-uh-fil-ik) esophagitis (EoE) is an inflammation of the esophagus. Esophagus is the tube that sends food from the mouth to the stomach. The inflammation in EoE is made of a lot of orange-colored cells calles eosinophils, giving the name of the condition, eosinophilic esophagitis
Eosinophilic Esophagitis (click here to enlarge the image).
Does every patient need an endoscopy for a diagnosis of EoE?
Probably yes. All eosinophilic GI conditions require a clinical diagnosis (symptoms) and pathological diagnosis (biopsy) to make sure the two of them match.
What are the different diet approaches to EoE?
There are 3 basic dietary approaches to EoE:
1. Elemental diet.
2. Elimination based on allergy testing.
3. Empirical elimination of the top 6 allergens, called SFED (six-food elimination diet).
How accurate is allergy testing for EoE?
It's not great. Both skin testing and blood testing (ImmunoCAP) are designed for immediate IgE-reactions. Both tests work "so-so" for EoE. They are helpful if they are negative. Patch testing is experimental. However, if a patient is negative on both skin prick and patch testing, they have a better than 90% chance of not having a problem with that particular food (with the exception of milk).
How long can someone stay on topical steroid therapy?
For years. There are no long term data, but the experts think that, similarly to inhaled steroids for asthma, patients with EoE can stay on swallowed steroid for years not have a problem.
How does a parent know when their child is responding to a treatment?