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Your Guide to Eosinophilic Esophagitis

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This content is created or selected by the Healthgrades editorial team and is funded by an advertising sponsor. The content is subject to the Healthgrades medical review process for accuracy, balance and objectivity. The content is not edited or otherwise influenced by the advertisers appearing on this page except with the possible suggestion of the broad topic area. For more information, read the Healthgrades advertising policy.

Food Impaction and Eosinophilic Esophagitis

Medically Reviewed By Cynthia Taylor Chavoustie, MPAS, PA-C

People with eosinophilic esophagitis (EoE) may experience food allergies. However, you can also be mindful about how you eat your food since people with EoE can be more likely to experience food impaction.

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Choking while you’re trying to swallow may be concerning. If you have an allergic condition of the esophagus called EoE, there can be an increased risk of choking while eating. That’s because white blood cells build up in your esophagus, causing inflammation, which can make it difficult to eat and swallow.

How does food get stuck in your esophagus? You may swallow a bite of food without chewing it enough. Then this large piece of food can get stuck in your throat or esophagus. You may begin to choke or feel like you have something caught in your chest.

Some people with food stuck in their esophagus might also feel a squeezing sensation in their chests, which can be alarming because it can mimic the sensation of having a heart attack. It’s also possible to experience pain while swallowing. 

In a person with EoE, the esophagus can narrow due to inflammation, making it even easier for a piece of food to get stuck instead of safely traveling down the esophagus into the stomach. A 2021 research review suggested that food bolus impaction can affect 33–55% of children and adults with EoE.

Eating to avoid impaction

If you want to avoid that scary choking or “stuck in the chest” sensation, you can be especially mindful of what you eat and how you eat it. The following strategies experts often recommend to people with dysphagia, or difficulty swallowing, may help you avoid that sensation:

  • Chew your food thoroughly before you try to swallow.
  • Sit up while you eat.
  • Avoid eating dry, dense foods, which can easily get stuck in an inflamed esophagus.
  • Be especially careful when eating meat, as meat is one of the foods most commonly associated with impaction.
  • Drink water with your food.

Reducing the inflammation in the esophagus that can lead to food impaction is also a good idea. One way to do that is to avoid food allergens that tend to trigger inflammation of the esophagus. 

Medications to avoid impaction

In addition to using strategies to avoid food impaction, you may need to take medications to help relax the esophagus.

The only medication currently approved by the Food and Drug Administration to treat EoE is a monoclonal antibody called dupilumab (Dupixent). Injected weekly, Dupixent can reduce the inflammation that narrows the esophagus and makes it hard to swallow food. The inflammation reduction may help you avoid food impaction.

Proton pump inhibitors, often used to treat gastroesophageal reflux disease, or topical steroids, which people can swallow as a liquid or from an inhaler, can also help you avoid food impaction.

Treating the impaction

A couple of medications can help treat food impaction as it occurs. Some people with EoE may find glucagon or butylscopolamine effective at reducing esophageal spasms.

Sometimes, an endoscopy is necessary to remove the food impaction because it becomes severe or other treatments are ineffective.

In fact, research Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source suggests that half of all endoscopies for food impaction removal link to EoE cases. Your doctor will thread a thin, flexible tube into your esophagus and then remove the impacted food with instruments. 

If you feel something get stuck in your esophagus and you can’t clear it, contact your doctor about treatment.

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  1. Dysphagia. (2017). https://www.nidcd.nih.gov/health/dysphagia
  2. Eosinophilic esophagitis. (2023). https://www.aaaai.org/Conditions-Treatments/related-conditions/eosinophilic-esophagitis
  3. Eosinophilic esophagitis. (2023). https://rarediseases.org/rare-diseases/eosinophilic-esophagitis/
  4. Gurala D, et al. (2021). Esophageal food impaction: A retrospective chart review. https://www.gastrores.org/index.php/Gastrores/article/view/1387
  5. Hackett R, et al. (2021). Management of adults with acute oesophageal soft food bolus and foreign body obstructions at two New Zealand district health boards. https://www.dovepress.com/management-of-adults-with-acute-oesophageal-soft-food-bolus-and-foreig-peer-reviewed-fulltext-article-CEG
  6. Hiremath GS, et al. (2015). Esophageal food impaction and eosinophilic esophagitis: A retrospective study, systematic review, and meta-analysis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4624046/
  7. Muir AB, et al. (2016). Role of endoscopy in diagnosis and management of pediatric eosinophilic esophagitis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5000297/
  8. Nguyen N, et al. (2021). Endoscopy in pediatric eosinophilic esophagitis. https://www.frontiersin.org/articles/10.3389/fped.2021.713027/full
  9. Shafique M, et al. (2013). New and safe treatment of food impacted in the esophagus: A single center experience of 100 consecutive cases. https://www.hindawi.com/journals/grp/2013/142703/
  10. Stemberoski L, et al. (2018). Medical management of esophageal food impaction refractory to endoscopic interventions. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5952287/

Medical Reviewer: Cynthia Taylor Chavoustie, MPAS, PA-C
Last Review Date: 2023 Jul 12
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