What are the symptoms of eosinophilic oesophagitis?

Written by: Dr Aathavan Loganayagam
Published:
Edited by: Laura Burgess

Eosinophilic oesophagitis is a chronic inflammatory condition that affects the oesophagus (food pipe). This condition is characterised by white blood cells known as “eosinophils” being present in the lining of the oesophagus due to allergy or infection. Eosinophilic oesophagitis seems to be more common in people with allergic conditions such as food allergy, eczema, allergic rhinitis or asthma.

Leading London gastroenterologist Dr Aathavan Loganayagam explains the signs of eosinophilic oesophagitis in both adults and children and how it is treated.

What are the symptoms of eosinophilic oesophagitis?

The initial symptoms of eosinophilic oesophagitis may occur at any age. In young children, the condition should be considered if there are reflux-like symptoms (e.g. vomiting, regurgitation, abdominal discomfort) or persistent feeding problems.

In older children and adults, difficulty swallowing and food impaction in the oesophagus are the symptoms. Eosinophilic oesophagitis should also be considered in people with gastro-oesophageal reflux disease who are not responding well to treatment.
 

How is eosinophilic oesophagitis diagnosed?

The diagnostic criteria for eosinophilic oesophagitis are:

  • Characteristic symptoms
  • Endoscopy – there are several characteristic findings at gastroscopy which can suggest eosinophilic oesophagitis.
  • A large number of eosinophils in oesophageal biopsies – these biopsies can be performed during a gastroscopy procedure. Oesophageal eosinophils may also be seen in gastro-oesophageal reflux disease.
  • Specific blood tests – (e.g. eosinophil count, IgE level) may provide supportive evidence for the condition.
     

Finally, it is also important to exclude other conditions which may have symptoms similar to eosinophilic oesophagitis.
 

How is eosinophilic oesophagitis treated?

In the short term, the patient can experience relief with steroids, which are swallowed to coat the lining of the oesophagus. However, the mainstay of therapy is to identify a dietary cause for eosinophilic oesophagitis and to eliminate the offending food.

This is a complex process usually requiring the help of an expert dietitian. Common foods that cause eosinophilic oesophagitis include milk, egg, wheat, soy, peanuts/tree nuts, and seafood (fish/shellfish).
 

Can eosinophilic oesophagitis cause cancer?

There is no reported evidence of a link between eosinophilic oesophagitis and cancer.

 

Book an appointment with Dr Loganayagam if you are concerned that you are living with the condition.

By Dr Aathavan Loganayagam
Gastroenterology

Dr Aathavan Loganayagam trained in medicine at Guy’s, King's and St. Thomas’ medical schools. He then underwent rigorous structured specialty training in gastroenterology and general internal medicine in the well respected South London training programme.

He then spent two years during postgraduate training as a research and endoscopy fellow at Guy’s and St Thomas’ Hospitals, London. His research was in the fields of pharmacogenetics, inflammatory bowel disease and gastrointestinal malignancy. He has received awards and grants for outstanding research work, including the prestigious NHS Innovation London Award.

Dr Loganayagam has numerous publications in peer reviewed journals on all aspects of gastroenterology. He is actively involved in clinical research. He has particular local expertise in the practice of personalised medicine and the utilisation of novel therapeutic agents in the treatment of complex inflammatory bowel disease. He is currently the lead clinician for endoscopy at Queen Elizabeth Hospital, Woolwich.

Diagnostic and advanced therapeutic endoscopy remains a major part of his clinical expertise, including assessment and treatment of inflammatory bowel disease, strictures, polyps and cancers.

Dr Loganayagam is an approachable doctor who takes pride in his communication skills with patients. He is keen to ensure that patients are fully informed and involved in all aspects of their care.

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