ORLANDO, Fla. (Ivanhoe Newswire) — It is commonly mistaken for GERD, but eosinophilic esophagitis, or EoE for short, is a chronic condition in where there is irritation and inflammation of the esophagus. For some it can make it difficult to eat and swallow foods and inhibit growth in young children. Ivanhoe has details on what people should look out for and how EoE can be treated.
Seventeen-year-old Will Moore dominates the soccer field.
“Soccer is something I do every week,” stated Will.
And a healthy diet fuels his energy. But a few years ago, the food he was eating was causing him to have an allergic reaction. In a matter of three months …
“I had three or four anaphylactic reactions,” Will revealed.
Laura Moore, Will’s mom, shared, “It was definitely a challenge and very scary.”
Doctors diagnosed will with eosinophilic esophagitis, or EoE for short.
“Basically, this is the body reacting mostly to foods and causing inflammation or swelling in the esophagus,” explained James P. Franciosi, MD, Division Chief of Pediatric Gastroenterologist at Nemours Children’s Hospital in Orlando, Florida.
Symptoms of the condition can include trouble swallowing, heartburn, chest pain, vomiting, even trouble growing for some kids.
“If left untreated, you could develop scar tissue in the esophagus, and sometimes you could develop a narrowing or what’s called a stricture,” continued Dr. Franciosi.
To treat EoE, a patient’s diet is stripped of most food. Then foods are slowly reintroduced, and an endoscopy is performed to monitor the number of eosinophils, a type of white blood cell related to allergies and inflammation, in the esophagus.
“If it’s a high number, then you know you can’t eat that food and if it’s a low number, then you know that’s a safe food,” shared Will.
Will’s diet now consists mainly of red meats, rice, fruits and vegetables. He also takes medication to control his symptoms.
“He’s feeling a lot better. He’s able to gain weight. He’s playing sports,” smiled Laura.
And he’s scoring a goal in the fight against EoE.
There are several types of EoE. Doctor Franciosi said that Will has a more severe type, which involves more food restrictions. Many children with EoE do well with only a dairy restriction or a four-food restriction. Will also has a brother with a less severe form of EoE.
Contributors to this news report include: Milvionne Chery, Producer; and Roque Correa, Editor and Videographer.
EoE: THE FOOD ALLERGY DISEASE
BACKGROUND: A chronic disorder of the digestive system in which large numbers of a particular type of white blood cell, called eosinophils, are present in the esophagus is known as eosinophilic esophagitis, or EoE. Eosinophils play a role in immune regulation and fighting certain infections, and their accumulation may be caused by many factors such as immune hypersensitivity responses to particular foods or environmental proteins (allergens) in some affected individuals. A particular gene called eotaxin-3 has been found to have an unusually high expression in some individuals. This condition can be characterized by vomiting, stomach or chest pain, failure to thrive (particularly in children), difficulty swallowing, and food getting stuck in the throat. The frequency of EoE has been estimated to be approximately 1 in 2,000 individuals and has been reported in multiple continents including Europe, Australia, and America.
EoE RELATED DISORDERS: There are some disorders that show similar symptoms as EoE. Gastroesophageal reflux disease (GERD) is a digestive disorder characterized by reflux of the contents of the stomach or small intestines into the esophagus. Symptoms of GERD may include a sensation of warmth or burning rising up to the neck area (heartburn or pyrosis), swallowing difficulties (dysphagia), and chest pain. Ulcerative colitis is an inflammatory bowel disease (IBD) of unknown cause. It is characterized by chronic inflammation and ulceration of the lining of the major portion of the large intestine (colon). Although symptoms usually become apparent during adolescence or young adulthood, some individuals may experience an initial episode between 50 and 70 years of age. Crohn’s disease is an inflammatory bowel disease characterized by severe, chronic inflammation of the intestinal wall or any portion of the gastrointestinal tract. Symptoms may include watery diarrhea, abdominal pain, fever, and weight loss.
SUCCESSFUL TREATMENT FOR EoE: A recent report was published on a patient who was diagnosed with EoE at 25 years old with a history of allergic conditions like pollen food syndrome, asthma, chronic sinusitis, urticarial disorder, as well as rheumatoid arthritis. It was noted that after 3 months of therapy with tofacitinib, a Janus kinase (JAK) inhibitor, he greatly improved. The patient’s initial endoscopy revealed ringed esophagus, longitudinal furrows, and white plaques, which are typical esophageal mucosal changes for patients with EoE. He was enrolled in the RECEPTOS clinical trial, which evaluated RPC4046, a monoclonal antibody against IL-13, and reported a moderate improvement in his gastrointestinal and allergic symptoms. But there was no improvement in his joint pain. After the trial concluded, tofacitinib 5mg was started twice daily to control the patients rheumatoid arthritis. After 3 months of therapy, a significant improvement in gastrointestinal and joint pain symptoms was observed and an upper endoscopy revealed a normal appearance of his esophagus.
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