Eosinophilic Esophagitis (EE):
A recent issue of Food Allergy News, the journal of the US Food Allergy and Anaphylaxis Network (www.foodallergy.org) featured an article by Drs Terri Brown-Whitehorn and Chris Laicouras, Professors, respectively of Clinical Paediatrics and Paediatric Gastroenterology at University of Pennsylvania School of Medicine. We thought Foods Matter readers would find it interesting.
Eosinophilic esophagitis, or EE for short is a disorder that affects people of all ages and involves a type of allergic reaction to food. EE has been getting an increasing amount of attention over the past 10 years from doctors and nutritionists as well as from the general public. There has been a dramatic rise in the number of new cases in the United States, Canada, Australia and parts of Europe. Current best estimates are that EE occurs in at least 10,000 people.
With infants and toddlers, families often note feeding difficulties, irritability, and, occasionally, poor weight gain. Older children typically have regurgitation, vomiting, heartburn and ‘belly pain’.
EE is diagnosed when the number of eosinophils in the esophagus exceeds an established threshold in those who also show symptoms of this disorder.
Unlike patients with recurring heartburn (gastroesophagal reflux) who respond to medication, EE patients respond to the removal of foods from their diets.
Environmental allergens are also addressed and managed by the allergist. However, it is rare for them to play a role in EE.
Steroid and dietary manipulations
Steroids taken in a pill form (prednisolone) or swallowed as a topical spray (Flovent® and Beclomethasone) have been shown to relieve symptoms and tissue damage in many patients. Unfortunately, when these medications are discontinued, the disease almost always recurs.
Other drugs, such as Cromolyn sodium (Intal®) and montelukast (Singular®) have not been shown to be effective.
A follow-up endoscopy with biopsy is recommended six weeks after beginning treatment, to determine if the suspected foods are in fact causing the disorder.
This type of follow-up is repeated at intervals to keep track of the patient’s progress, because an improvement in symptoms does not always mean the the condition itself has improved.
Unfortunately, there are currently, no non-invasive methods for the physician to use to follow the progress of someone with EE.
Courtesy of FAAN www.foodallergy.org
For further information on eosinophilic diseases check
First published in 2007
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