The link between heartburn and hay is a disease called eosinophilic esophagitis (EOE). You have probably never heard of EOE, but awareness of this illness is spreading in the GI community. If you have been experiencing symptoms such as heartburn or acid reflux, or even difficulty eating, relief may lie in an EOE diagnosis.
What Is EOE?
EOE is a buildup of allergy cells (eosinophils) in the tissue of the esophagus. The esophagus becomes inflamed and makes it more difficult to move food through and into the stomach. This happens because of the immune system’s response to allergies. Although food is the most common type of allergy to be associated with EOE, GI doctors suspect environmental allergies can also have the same effect, especially since the illness is more frequently diagnosed in the spring when allergy-causing plants are blooming.
The only way to diagnose EOE is through an upper endoscopy and biopsy of the esophagus tissue. However, there are a number of symptoms that you and your doctor can use to evaluate whether you might be suffering from EOE. These symptoms include things like frequent cough or irritated throat, nausea, or difficulty sleeping due to abdominal pain or reflux. It can also include more serious things like difficulty swallowing, vomiting, food getting stuck in the esophagus, or chest pain. Many of these symptoms overlap with and could be mistaken for gastroesophageal reflux disease (GERD). A key difference between the two is that symptoms of EOE don’t get better with typical heartburn medication.
Because EOE is brought on by allergies, it makes sense that you would need to discover if you do, in fact, have an allergy that is causing the problem. Since the most commonly associated allergy is food, the most common allergy tests will be dietary. Your doctor may eliminate certain foods or add foods incrementally to see if this triggers EOE symptoms. He may also recommend allergy testing, which can help identify both food and environmental allergens.
What Do I Do?
EOE is not life-threatening, but left untreated, it could cause damage to the esophagus. While the disease does not have a cure, it can be managed through medication and/or dietary changes. Through allergy testing or process-of-elimination dietary management, you and your doctor can start to identify which allergens are causing problems and treat those directly. The FDA has not yet approved a medicine for EOE, but there are a few that have been shown to help. Just like other types of reflux, eating less spicy or acidic foods, limiting caffeine and carbonated beverages, and not eating before you go to bed may help lessen the discomfort of EOE symptoms as well.
EOE is a complex disorder and can be overwhelming for patients. Discussions and frequent checkups to see how the disease is progressing are important. If you have more questions or think you might be suffering from EOE, don’t delay! Contact Dr. Sameer Islam today to make an appointment.