Eosinophilic Esophagitis (Pediatric)
Eosinophilic Esophagitis (Pediatric)
What is eosinophilic esophagitis?
Eosinophilic esophagitis, or EoE, is inflammation of the esophagus (swallowing tube) that is related to allergies. Eosinophils are a type of white blood cell that is involved in allergic reactions. Normally, the esophagus has almost none present. For people with EoE, these white blood cells build up in the esophagus, resulting in inflammation. While the cause of EoE is not well understood, the general belief is that it’s likely due to sensitivity to specific foods or possibly allergens in the air that are swallowed.
Our Approach
The C.S. Mott Children’s Hospital team has extensive experience diagnosing EoE and distinguishing between this condition and others with similar symptoms. Your care may include specialists in pediatric gastroenterology and possible pediatric allergy. Our physicians will work closely with your primary care provider and other specialists to coordinate your treatment and provide the best possible care.
Appointment Information
To learn more or schedule an appointment, contact our Pediatric Gastroenterology Clinic at 734-763-9650.
What are the symptoms of eosinophilic esophagitis?
It’s most common for EoE to present in childhood or early adulthood, but it can show itself at any age. In some people, symptoms can be very intermittent, such as trouble swallowing once every few months. Many people have had symptoms for years before a diagnosis is made. In adults, typical symptoms include:
- Trouble swallowing solid foods (also called dysphagia), including food impactions, which involves food getting stuck in the esophagus
- Recurrent vomiting immediately after eating
- Chest discomfort
- Heartburn that is refractory to medication
- Feeding disorders in younger children
How is eosinophilic esophagitis diagnosed?
To diagnose EoE, we discuss your symptoms and conduct a physical examination. Based on your risk factors, your doctor might recommend an upper endoscopy. Upper endoscopy, also known as an esophagogastroduodenoscopy or EGD, uses an endoscope—a lighted, flexible tube, about the thickness of a finger—to examine the upper gastrointestinal tract. A special instrument may be passed through the tube to take a small piece of tissue (a biopsy) for examination in the laboratory.
How is eosinophilic esophagitis treated?
The goal of treatment is to eliminate the eosinophils from the esophagus and to reduce symptoms. Standard treatments include:
- Topical steroids: The medication coats the lining of the esophagus and decrease inflammation, with very little if any getting absorbed and circulated to the rest of the body. Topical steroids can help decrease the number of eosinophils in the esophagus.
- Proton pump inhibitors: These medications, which are commonly used to treat heartburn and GERD, can treat effectively treat EoE in some patients and can be a good treatment option in those who respond.
- Biologic medications: Newer medications that target specific parts of the immune system that are overactive in EoE.
- Removal of most common allergen foods: The most common foods causing eosinophilic esophagitis can be removed from the diet (dairy, wheat, soy, and egg). Once symptoms have resolved, the eliminated foods are added back into the diet—one at a time—and the patient is observed for any reaction to the newly introduced foods.
Endoscopic dilation of strictures: Narrowings of the esophagus, called strictures, are dilated (widened) with an endoscope using balloons or tapered tubes. The widening allows food to pass more easily through the esophagus. Our multidisciplinary team includes experts in allergy, pathology, and radiology.
Locations
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Pediatric Gastroenterology Clinic | C. S. Mott Children's Hospital 1540 E Hospital Dr
Floor 8 Reception B
Ann Arbor, MI 48109-4259Get Directions -
Pediatric Gastroenterology Clinic | Northville Health Center 39901 Traditions Dr
Floor 2
Northville, MI 48168-9493Get Directions -
Pediatric Gastroenterology Clinic | Trinity Health Oakland Hospital 44555 Woodward Avenue, Suite 505
Pontiac, MI 48341Get Directions -
Pediatric Gastroenterology | Brighton Center for Specialty Care 7500 Challis Rd
Entrance 1, Level 2
Brighton, MI 48116-9416Get Directions
Doctors
Jeremy Adler, MD, MSc
Clinical Professor
Pediatric Gastroenterology, Pediatrics
Adam Cardullo, MD
Clinical Assistant Professor
Pediatric Gastroenterology, Pediatrics
Chris John Dickinson, MD
Professor
Pediatric Gastroenterology, Pediatrics
Lindsey Suzanne Lawrence, MD
Clinical Assistant Professor
Pediatric Gastroenterology, Pediatrics
Grace Jennifer Lee, MD
Clinical Assistant Professor
Pediatric Gastroenterology, Pediatrics
Maclovio James Lopez, MD, PhD
Clinical Professor
Pediatric Transplant Hepatology, Pediatric Gastroenterology, Pediatrics
Shuemein Julia Mar, MD
Clinical Assistant Professor
Pediatric Gastroenterology, Pediatrics
Victoria Shakhin, MD, MSc
Clinical Assistant Professor
Pediatric Transplant Hepatology, Pediatric Gastroenterology, Pediatrics, Transplant Hepatology
Andrew A Singer, MD
Clinical Associate Professor
Pediatric Gastroenterology, Pediatrics
Alejandro Velez Lopez, MD
Clinical Assistant Professor
Pediatric Gastroenterology, Pediatrics
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