Pediatric Eosinophilic Esophagitis (EoE)

Pediatric Eosinophilic Esophagitis (EoE)

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Summary

Eosinophilic esophagitis (EoE) causes a type of white blood cell – known as eosinophil – to build up in the esophagus and lead to problems with eating and drinking.

Expanded overview

In a child with eosinophilic esophagitis (EoE), eosinophil (a type of white blood cell) unusually accumulates in the lining of the esophagus (tube that connects the mouth to the stomach). This collection of eosinophil can react to foods, allergens or acid reflux, and lead to inflammation or injury of the tissue of the esophagus. Inflamed (swollen) esophageal tissue can cause problems when a child tries to swallow or eat food.

EoE is considered to be a chronic (ongoing) disease of the immune system. It is a relatively new identified disorder, but is considered to be a major gastrointestinal disease. EoE occurs more frequently in males than it does in females.

Causes

Eosinophils naturally occur in the digestive tract. However, a child with EoE has an abnormal allergic reaction to eosinophils. The allergic reaction that causes EoE may include:

  • Inflammation of the esophagus – lining of the esophagus reacts to an allergen, such as food or pollen
  • Injury to the esophagus – inflammation of the esophagus over time can cause scarring, narrowing and forming of fibrous tissue
  • Multiplication of eosinophils – eosinophils in the esophagus multiply unusually and produce a protein that leads to inflammation

Symptoms

Signs and symptoms of this condition can include:

  • Difficulty swallowing (dysphagia) 
  • Failure to thrive (not reaching growth or development milestones as expected for child’s age)
  • Food stuck in the esophagus after trying to swallowing (known as impaction)
  • No improvement after taking gastrointestinal esophageal reflux disease (GERD) medication
  • Pain in the abdomen
  • Trouble eating
  • Vomiting

Treatment

Treating EoE with a comprehensive plan

  • Our pediatric specialists are experts in diagnosing and treating digestive and nutrition issues in children. We tailor our approach, using child-friendly language, equipment and amenities to help the children we see feel comfortable and at ease. 
  • When we see your child for an initial visit, you can expect us to thoroughly review medical records, including surgeries or endoscopies, blood work and allergy testing.
  • Next steps may involve additional blood tests, endoscopy, allergy testing and imaging. We will engage our entire team in developing a treatment plan. A food elimination diet is a common course of action, and we may introduce steroids and/or medications used to treat GI inflammation.

FAQs

Should my child see a specialist?

Talk with your pediatrician about the symptoms of EoE. He or she will tell you that in young children, EoE may cause chronic vomiting and poor growth. Older children may describe difficulty swallowing. Symptoms may include a combination of the following:

  • Refusing to eat, breast feed or take a bottle
  • Choking and gagging on certain foods
  • Food getting stuck in the esophagus
  • Vomiting
  • Stomach pain
  • Reflux symptoms that do not respond to anti-reflux medication

If you think your child may have EoE or an eosinophilic gastrointestinal disorder (EGID), our team, collaborating with your primary care provider, can provide answers and a plan.

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