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Path to Dysphagia Diagnosis
  • Writer's pictureCarinda Stout, MS CCC/SLP

What is Eosinophilic Esophagitis (EoE)?

Eosinophilic esophagitis (EoE) is difficulty in swallowing solid food (dysphagia) due to allergies. Specifically, the food becomes stuck in the esophagus after it is swallowed. Other symptoms include coughing, heartburn, and chest pain.

Eosinophils are white blood cells manufactured in the bone marrow and are one of the many types of cells that actively promote inflammation. They are particularly active in the type of inflammation caused by allergic reactions. A large number of eosinophils can accumulate in tissues such as the esophagus, the stomach, the small intestine, and sometimes in the blood when individuals are exposed to an allergen. The cause of eosinophilic esophagitis is unknown. It is not even known whether the allergen is inhaled or ingested.

The food becomes stuck in the esophagus after it is swallowed.

Eosinophilic esophagitis decreases the ability of the esophagus to stretch and accommodate mouthfuls of swallowed food probably as a result of the presence of so many eosinophils but also, perhaps as a result of some scarring that occurs in the wall of the esophagus. As a result, solid foods (particularly solid meats) have difficulty passing through the esophagus. When solid food sticks in the esophagus, it causes an uncomfortable sensation in the chest. If the solid food then passes into the stomach, the discomfort subsides, and the individual can resume eating.

Eosinophilic esophagitis can affect both children and adults. For unknown reasons, males are more commonly affected than females.

The diagnosis of eosinophilic esophagitis is established with a biopsy of the inner lining of the esophagus. A pathologist then can examine the biopsied tissue under a microscope to look for eosinophils.

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