Eosinophilic Esophagitis in Children
Watching your child struggle with symptoms like difficulty swallowing or food getting stuck in their throat can be alarming, but eosinophilic esophagitis (EoE) can be effectively managed with the right care. At RWJBarnabas Health, we recognize the unique challenges that EoE presents. Our pediatric gastroenterology specialists provide comprehensive, compassionate care to enable your child to manage this condition.
What Is Eosinophilic Esophagitis?
Eosinophilic esophagitis (EoE) is a condition in which eosinophils, which are a type of allergic white blood cell, cause inflammation in the esophagus (the food pipe). EoE is more common in boys, especially those who have other allergic conditions such as eczema or asthma. Over the past three decades, there has been a growing awareness and diagnosis of EoE.
Eosinophilic Esophagitis Causes
The exact cause of pediatric eosinophilic esophagitis is not fully understood, but genetics appear to play a role since it can run in families. Typically, EoE is due to a food allergy, and rarely, it’s caused by an environmental allergy. The food allergy might involve one or multiple food groups, with common culprits being milk, wheat, egg, soy, fish and nuts.
Eosinophilic Esophagitis Symptoms
The symptoms of EoE can vary depending on the child's age. In young children, EoE might cause vomiting or difficulty transitioning to solid foods. Older children might experience belly pain, chest pain or have food get stuck in their esophagus.
Children with EoE often chew their food thoroughly and slowly, may drink liquids to help push food down, and might be the last to finish their meals.
Eosinophilic Esophagitis (EoE) Diagnosis
EoE is diagnosed through an upper endoscopy, a procedure in which a small camera is used to look inside the esophagus. The esophagus might show specific features like vertical furrows, white patches, swelling or narrowing. Biopsies taken during the endoscopy showing 15 or more eosinophils per high-powered field confirm the diagnosis. Sometimes, an endoscopy is also needed to remove food stuck in the esophagus, although the stuck food isn't necessarily the cause of EoE.
Eosinophilic Esophagitis (EoE) Treatment
Treating EoE involves a collaborative approach between the child, their family or guardian, and their health care provider. Our team of specialists works closely with patients and families to create personalized treatment plans and provide ongoing care and support.
Since EoE is a lifelong condition, any chosen treatment is likely needed for life. Treatment options include:
- Dietary management. Eliminating specific foods for about two months to identify and avoid triggers. This process may need to be repeated to pinpoint exact triggers since standard allergy testing is not helpful for EoE.
- Topical steroids. Swallowed steroids that coat the esophagus to reduce inflammation.
- Proton pump inhibitors. Medications traditionally used for acid-related issues that also help reduce allergic inflammation.
- Biologics. These target specific parts of the immune system and can also help with asthma and eczema.
Repeat endoscopies are necessary to ensure the inflammation has improved or resolved since symptoms might improve without the eosinophilic inflammation being fully treated. If untreated, EoE can lead to narrowing (stricture) of the esophagus.
Help for Eosinophilic Esophagitis
While there is no known prevention for EoE, early diagnosis and treatment can help manage symptoms and prevent complications. Regular follow-up and monitoring are essential to ensure effective management of the condition.
If your child is experiencing symptoms of EoE, or if you have concerns about their esophageal health, please contact our pediatric gastroenterologyteam today to schedule a consultation.