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| What is Eosinophilic Esophagitis (EE)?
Eosinophilic esophagitis (EE) is an allergic inflammatory reaction of the esophagus (the tube that connects the throat and the stomach) which causes vomiting, and painful swallowing and digestion. Also known as allergic esophagitis, EE is a newly diagnosed disease whose symptoms mimic some of those associated with GERD.
EE is caused by a large build up of eosinophils in the esophagus. Eosinophils are a type of white blood cell. Designed to respond to parasites, eosinophils are normally found in the intestines and are not supposed to be present in the esophagus.
Although the disease occurs in adults, most cases of EE have developed in children. It is not fully known why the disease occurs more often in children. EE occurs more commonly in boys than in girls. In comparison, most adults affected by the condition are men in their 20s and 30s.
Incidence of EE is on the rise, with an increasing number of EE cases having been diagnosed within the last five years. Physicians do not completely understand whether EE is occurring more often or if it is just being diagnosed more frequently.
The origin of EE is an allergic reaction, which involves the immune system’s inappropriate response to a protein. The body perceives the protein to be harmful, and produces immunoglobulin E (IgE) antibodies to defend against the "invader." When the IgE antibodies come in contact with the offending protein, chemicals known as histamines and leukotrienes are released, causing the symptoms most people associate with allergies, including itchiness, rashes, hives, swelling, nausea, diarrhea and shortness of breath.
Food allergies such as milk, eggs, nuts, wheat, soy, corn and shellfish are the cause of 80 percent of EE (according to AAAI).
EE can be treated by avoiding the allergen causing the reaction. In the case of food allergy, the preferred treatment method is strict avoidance of the problem food. An elimination diet may need to be undertaken to identify the particular food(s) causing the allergy and a special diet may need to be developed for the long term. An environmental allergy may be treated by a combination of avoidance and medications such as antihistamines.
EE may be misdiagnosed as GERD as some of the symptoms are similar, and GERD is common. However, symptoms of EE do not improve with acid blockage medications like those used to treat GERD. EE does appear to improve with an elimination diet to remove the food allergen source or with corticosteroid medications commonly used to treat asthma.
Left untreated, the inflammation related to EE will begin to damage the esophagus, resulting in narrowing of the esophagus (stricture) and in increase in fibrous tissue (fibrosis).
How does eosinophilic esophagitis cause dysphagia?
Eosinophilic esophagitis decreases the ability of the esophagus to stretch and accommodate mouthfuls of swallowed food. As a result, solid foods (particularly steak, turkey, and chicken) will have difficulty passing through the esophagus. When solid food sticks in the esophagus, it causes an uncomfortable sensation in the chest, referred to as dysphagia. If the solid food then passes into the stomach, the discomfort subsides, and the individual can resume eating. If the solid food does not pass into the stomach, individuals often must regurgitate the food by inducing vomiting before they can resume eating. Rarely, the solid food becomes impacted, that is, it can neither pass into the stomach or be regurgitated. The impacted solid food causes chest pain that can mimic aheart attackand repeated spitting of saliva that cannot be swallowed (because of the obstruction of the esophagus). Individuals with impacted food are unable to eat or drink. To relieve the obstruction, a doctor usually will have to insert a flexible endoscope through the mouth and into the esophagus to remove the impacted food.
How eosinophilic esophagitis causes symptoms of abdominal pain, vomiting, and failure to thrive in children is not clear.
Source:
medicinenet.com
about.com:allergies
yourtotalhealth.ivillage.com
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