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Your Guide to Eosinophilic Esophagitis

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Advances in Treating Eosinophilic Esophagitis

Medically Reviewed By Kelsey Trull, PA-C

Because eosinophilic esophagitis (EoE) isn’t a common condition, you often have to try a few different treatments to find the one that reduces your symptoms.

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Eosinophilic esophagitis (EoE) is a chronic allergic condition causes white blood cells called eosinophils to build up in the esophagus.

These immune cells cause inflammation, which leads to symptoms such as:

  • difficulty swallowing
  • nausea
  • appetite loss
  • stomach discomfort
  • difficulty eating

In 2022, the Food and Drug Administration (FDA) approved a medication to relieve EoE symptoms. Ongoing research could lead to new treatment options that improve your quality of life.

Diagnosing eosinophilic esophagitis

Eosinophilic esophagitis (EoE) is a rare condition, affecting only 10 in 100,000 Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source people. To get started on the right treatment for EoE, a doctor may confirm the diagnosis. EoE can be challenging to diagnose because symptoms are similar to gastroesophageal reflux disease (GERD). Both conditions may cause heartburn, trouble swallowing, and chest pain.

No specific test can diagnose EoE, so doctors begin by ruling out GERD and other conditions with similar symptoms.

A test called endoscopy is an option if you have symptoms such as trouble swallowing. The doctor uses a thin tube called a scope to look inside the esophagus and remove small samples of tissue. A lab tests those samples to see how many eosinophils they contain.

Testing for different allergic conditions may also be helpful. Most people with EoE also have immune conditions, such as:

Allergies to substances in the environment such as pollen, dust mites, and mold may play a part in EoE. It can be common Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source to have EoE and GERD at the same time.

Treatments for eosinophilic esophagitis

The goals in treating EoE are to relieve symptoms and put the disease into remission, which means there are no more signs of eosinophils in the esophagus.

Because research hasn’t shown that one treatment works better than another, finding the most effective therapy can take some trial and error. You can work with a doctor to try a few different therapies or combinations and create a treatment plan that works for you. 

A doctor may suggest drugs called proton pump inhibitors to reduce acid production in the stomach and bring down inflammation in the esophagus. Still, these may not ease symptoms for everyone with EoE.

Topical steroids can also be an option to help lower inflammation and relieve trouble swallowing. Steroids come in a spray and as a pill that dissolves on the tongue.

Dietary changes are an essential part of EoE treatment. An elimination diet can be the first step to understanding your specific dietary needs. Some common food allergens can include:

  • cow’s milk
  • wheat
  • nuts
  • eggs
  • soy

Working with a registered dietitian can help you find a dietary plan that fits your needs.

If initial treatment options don’t lower inflammation and relieve symptoms, an esophageal dilatation can widen the esophagus to make swallowing easier.

New medications for eosinophilic esophagitis

A monoclonal antibody is now available to treat EoE by blocking a substance that causes inflammation in the esophagus. This medication is a weekly injection approved by the FDA for children and adults ages 12 and older. 

Researchers are studying other monoclonal antibodies in clinical trials. Some of the medications that have shown promise for treating EoE are:

  • bevacizumab (Avastin)
  • cendakimab (Anti-IL-13)
  • lirentelimab (Lirentelimab)

Further research is needed to learn whether these other monoclonal antibodies work for EoE treatment, or whether other types of drugs could be effective.

Joining a clinical trial is a way to try a new treatment under medical supervision. Participating in one of these studies also helps researchers develop new therapies for EoE.

Many clinical trials on EoE are underway. If you’re interested in joining one of these studies, a doctor can help you find one that’s a good fit.

Takeaway

New treatments can help you find new ways to manage symptoms. EoE is a complex condition, so working with a doctor is the best way to get a specific diagnosis and find treatment.

An allergist or immunologist can help you identify food allergens and recommend next steps, while a  gastroenterologist can prescribe medications to manage inflammation in your esophagus. 

Ask a doctor about the latest EoE treatments and how these can improve your quality of life.

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  1. Dellon, ES, et al. (2018). Epidemiology and natural history of eosinophilic esophagitis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5794619/
  2. Eosinophilic esophagitis. (2022). https://acaai.org/allergies/allergic-conditions/eosinophilic-esophagitis/#
  3. FDA approves first treatment for eosinophilic esophagitis, a chronic immune disorder. (2022). https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-eosinophilic-esophagitis-chronic-immune-disorder

Medical Reviewer: Kelsey Trull, PA-C
Last Review Date: 2023 Sep 29
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