May 15, 2015

Does My Child Have GERD or EoE?

Children with eosinophilic esophagitis (EoE) may feel pain or a burning sensation in their chest, as well as difficulty swallowing.

When your child complains of a burning sensation in his chest, chest pain, chest tightness or regurgitation, you may feel concerned. When your child adds that he is having trouble swallowing and feels like something is stuck in his throat, though, you'll probably start to panic. But what is it? Chances are eosinophilic esophagitis (EoE) will not be the first thing you think of. 

What Is EoE?

EoE is a disorder where white blood cells (eosinophils) build up in the esophagus, causing inflammation. The exact causes are not completely understood, but it appears to be triggered by food allergies, airborne allergens and/orgastroesophageal reflux disease (GERD).

“If left untreated or not properly controlled, patients with EoE will develop fibrosis [scarring] along the esophagus, which will cause the esophagus to narrow and the patient to experience difficulty swallowing,” says Edaire Cheng, M.D., a Pediatric Gastroenterologist at Children’s Medical Center.

In addition, when EoE is left untreated, food will get stuck in the esophagus more often, and there is an increased risk of tearing or perforation of the esophagus.

The relationship between GERD and EoE is quite complex, and the two diseases may not be mutually exclusive,” Dr. Cheng says. “Therefore, both diseases are under high consideration as the gastroenterologist evaluates the patient.”

Similar Symptoms of EoE and GERD, Different Treatments

Some patients may experience symptoms of EOE as soon as a few hours after exposure to a trigger; others may not experience symptoms until they have had weeks of repeated exposure.

EoE - Thought to be an allergic process

Treatment for EoE is directed toward controlling the allergic inflammation or avoiding the allergic triggers.

Dietary therapy is a common form of treatment for EoE. “An allergy doctor can perform different types of allergy testing that may provide helpful information about what are likely, or not likely, triggers for a patient, which will allow the medical team to tailor the dietary therapy to the individual,” Dr. Cheng says.

Other noninvasive treatments include:

  • Medications to reduce stomach acid
  • Swallowed topical steroids

In some cases, if the fibrosis is very severe and caused extreme narrowing of the esophagus, a dilation procedure by endoscopy may be needed to provide therapeutic benefits,” says Dr. Cheng. The dilation procedure is done to stretch the narrowed portion of the esophagus.

GERD – Arises from acid reflux

GERD treatment is directed toward minimizing the amount and/or intensity of acid refluxing.

It is possible for a patient to have both GERD and EoE at the same. How much each disease contributes to the other disease is a matter of much debate and discussion in the gastroenterology field, and an immense amount of research is being dedicated to answering these questions.