Acid Reflux And Eosinophillic Esophagitis

By: GI Alliance


Acid reflux and eosinophillic esophagitis (EE or EoE) are medical problems that affect a large number of Americans. Both children and adults suffer from these ailments, which can cause a large amount of discomfort when it comes time to eat and digest.  Acid Reflux, or GERD, and eosinophilic esophagitis have similar symptoms and are EoE is commonly mistaken for GERD. What is Eosinophilic Esophagitis? Your esophagus is the large tube that connects your mouth to your stomach. Those who suffer from eosinophilic esophagitis experience an inflammation of the esophagus, which can result in a problem with swallowing. The reason for this inflammation is large numbers of white blood cells, specifically, ones called eosinophils, being congregated within the esophagus. Symptoms of eosiniophilic esophagitis typically include:
  • Poor weight gain also called “failure to thrive”
  • Refusal to eat (in children)
  • Vomiting following meals
  • Heartburn
  • Difficulty swallowing, called dysphagia
  • Pain or discomfort with swallowing referred to as odynophagia
  • Food impaction (lodged in the esophagus)
  • Coughing
  • Chest, throat, or abdominal pain
Interestingly, although all people can develop this condition, it is most commonly found in adult men and young boys. There has been rising incidence of EoE over the past few years, and more pediatricians, internists, and primary care physicians are becoming aware of and recognizing the disease.  It is often at that point that the patient is referred to a gastroenterologist for an endoscopic exam or biopsy. What Causes Eosinophilic Esophagitis?  There are many reasons why an individual might develop eosinophilic esophagitis. Several studies point to allergens in food for the development of eosinophilic esophagitis. The main reason for associating EoE with allergies is that eosinophils are found in high numbers in a large amount of other allergy-related conditions such as hay fever, asthma, and atopic dermatitis. Many believe that the most common reason for one to develop this condition is due to acid reflux. This assumption is incorrect, and EoE stands as a distinct disease whereby an allergic reaction in the esophageal lining occurs when exposed to allergens like food or pollen. What is Acid Reflux? Acid reflux is another common problem affecting 1 in 5 Americans. Acid reflux occurs when the lower esophageal sphincter allows stomach acids to escape back into the esophagus.  Acid reflux could be a persistent problem, or one that only occurs when the wrong foods or substances are ingested. Acid Reflux is caused when foods, drinks, or medications are ingested. If foods have a low pH balance, meaning they are acidic, then acid reflux can take hold. Other risk factors for acid reflux or GERD are being overweight or obese, smoking, lying down soon after eating, pregnancy, and taking aspirin, Ibuprofen, muscle relaxers or blood pressure medications. Those who suffer from acid reflux often experience heartburn, burning in their chest, rising up through their esophagus. The most common symptoms of acid reflux (GERD) are:
  • Heartburn
  • Regurgitation (the feeling of vomit or acid in the back of the mouth/throat)
  • Cough
  • Feeling a lump in the throat
  • Increased production of saliva
  • Laryngitis and hoarseness
  • Bad Breath
Treatment of acid reflux/GERD can be accomplished a number of ways. The first one typically recommended are lifestyle changes- get to a healthy weight, reduce consumption of foods and drinks that aggravate the condition, and stop smoking.  Beyond these, acid reflux treatments are available over the counter for infrequent issues, but for ongoing (chronic) sufferers, a physician will usually prescribe a proton pump inhibitor (PPI) to curb the amount of acid produced and escaping the stomach. Sometimes, a family history of swallowing problems or history of other allergic conditions in the patient, such as asthma, may also prompt consideration of eosinophilic esophagitis. Is There Anything to do to Treat Eosinophilic Esophagitis?  Fortunately, there are number of great ways to treat this condition. The most common practice for treating patients with eosinophilic esophagitis is through a process of dilating the esophagus and administering medicine. The process of gentle esophageal dilation moves or fractures the strictures of the esophagus, allowing for an easier passage for food. This can make patients who have had trouble swallowing feel much better, and allow them to eat without fear of discomfort or pain. The esophageal dilation needs to be done very carefully in patients with eosinophilic esophagitis, as opposed to other patients with swallowing problems. What Else Can Be Done to Prevent Eosinophilic Esophagitis?  There are many ways that an individual can try to prevent eosinophilic esophagitis from persisting or popping up again after being eliminated. An easy way to go about this is through the process of an elimination diet. An elimination diet is a common practice with those who might be developing an allergic reaction to certain kinds of foods. A great way to begin is by going to see an allergist and have them analyze your blood. They will administer a series of tests over the course of time to see if there is one specific thing that is causing your reaction. Another way to take part in an elimination diet is by paying attention to what you eat. Slowly weed out items from your daily diet that are large problems in the world of allergies. This includes dairy, soy, peanuts or tree nuts, shellfish, eggs and wheat. The difference between acid reflux and eosinophilic esophagitis is noted at microscopic examination of the tissue specimens obtained from the esophagus at endoscopy. Sometimes this is suspected, especially when a patient has had intermittent (sometimes infrequent) episodes of food getting stuck in the esophagus requiring ER visits for removal. Although some patients with eosinophilic esophagitis may improve with medication given for controlling acid, an accurate diagnosis may help in preventing future complications. Gastroenterologists Are the Experts When it comes to anything related to your digestive tract (which includes the stomach and esophagus), the physicians specializing in this field are gastroenterologists. They are specially trained and educated in assessing, diagnosing, and treating conditions of the gastrointestinal (GI) system. If you have been experiencing symptoms of EoE or GERD, schedule a consult with your nearest GI Alliance gastroenterologist.