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Your Guide to Eosinophilic Esophagitis

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6 Risks of Not Treating Eosinophilic Esophagitis

Medically Reviewed By Nicole Leigh Aaronson, MD, MBA, CPE, FACS, FAAP

Eosinophilic esophagitis (EoE) is a chronic condition of the esophagus. Untreated, EoE can worsen and lead to short-term and long-term complications.

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With EoE, your immune system overreacts to substances like nuts or milk, causing large numbers of white blood cells called eosinophils to multiply. The buildup of these cells can damage the lining of your esophagus.

Proton pump inhibitors (PPIs) and corticosteroids can reduce inflammation and prevent reflux, heartburn, and chest pain. Also, avoiding foods that trigger symptoms manages EoE in addition to an elimination diet, which can help prevent flares and damage to the esophagus.

Untreated EoE may cause the following risks or complications.

1. Narrowing of the esophagus

Constant inflammation gradually damages the lining of the esophagus. Just like scars form on injured skin, they can form inside a damaged esophagus.

Scarring narrows the esophagus, which is called stricture. Eventually, the esophagus can get so narrow that it becomes harder to swallow food. Dilation is a procedure doctors use to widen the esophagus to its original size.

2. Food slows or gets stuck

The esophagus is a tube. EoE scars narrow that tube, leaving less room for food. EoE can also slow the movement of food through the esophagus. You may notice that you have more trouble swallowing solid food.

Food also can become stuck in the esophagus, which is called impaction. Impaction is a medical emergency that needs to be treated in a hospital. Doctors use a flexible scope called an endoscope or a rigid scope to remove the stuck food.

3. You have more symptoms

Inflammation and scarring in the esophagus can cause symptoms such as:

  • abdominal pain
  • appetite loss
  • regurgitation
  • chest pain
  • food stuck in the throat
  • persistent heartburn
  • trouble swallowing
  • vomiting

The longer EoE goes untreated, the more severe these symptoms can become.

4. Holes and tears form in the esophagus

A damaged esophagus is more fragile, and it can tear. Perforation is the name for a tear in the esophagus. It’s rare, affecting only about 2% Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source of people with EoE. Still, it can be dangerous if food and fluids leak from the esophagus into the chest.

Perforation can happen from:

  • chronic inflammation in the esophagus
  • endoscopy procedures (if the scope tears the esophagus)
  • food getting stuck in the esophagus
  • intense or frequent vomiting

5. You don’t get enough nutrition

The esophagus is the main route food travels to reach your stomach. When the esophagus is damaged, you might not get enough food and nutrients.

Nutrient deficiencies happen in EoE because:

  • Narrowing of the esophagus makes swallowing food more uncomfortable or difficult. Some people avoid eating because they’re afraid that they’ll choke.
  • Symptoms like nausea, vomiting, and regurgitation reduce appetite.
  • Treating EoE often involves restrictive diets to eliminate trigger foods.

6. Your quality of life is affected

Living with a chronic condition significantly affecting your eating ability can cause stress and anxiety. EoE can cause worry about food choices and food getting stuck in the esophagus. These problems can affect your quality of life.

How to avoid complications

Though there’s no cure for EoE, treatments can help you manage symptoms, prevent complications, and improve your quality of life. Finding a culturally competent doctor you trust is the first step to controlling EoE.

Treating EoE is a team effort that involves a gastroenterologist, an allergist to help you identify your food triggers, and a registered dietitian to ensure you get enough nutrition.

Listen to your doctor’s advice and follow your treatment plan proactively for the best possible outcome. Learn about new treatment options so you know what’s available to you. Schedule regular follow-up visits so that your doctor can check you for signs of complications and manage them quickly if they happen.

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    1. Eosinophilic esophagitis. (2019). https://gi.org/topics/eosinophilic-esophagitis/
    2. Eosinophilic esophagitis. (2022). https://acaai.org/allergies/allergic-conditions/eosinophilic-esophagitis/
    3. Eosinophilic esophagitis. (2022). https://www.aaaai.org/conditions-treatments/related-conditions/eosinophilic-esophagitis
    4. Eosinophilic esophagitis (EoE). (n.d.) https://www.chop.edu/conditions-diseases/eosinophilic-esophagitis
    5. Furuta, G. T. (2015). Eosinophilic esophagitis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4905697/
    6. Hiremath, S. H. (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. Khan, S. (2021). An update on eosinophilic esophagitis: etiological factors, coexisting diseases, and complications. https://www.karger.com/Article/FullText/508191
    8. Lucendo, A. J. (2017). Determinant factors of quality of life in adult patients with eosinophilic esophagitis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5802671/
    9. Runge, T. M. (2017). Causes and outcomes of esophageal perforation in eosinophilic esophagitis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5368035/
    10. Votto, M. (2021). Malnutrition in eosinophilic gastrointestinal disorders. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7824578/


Medical Reviewer: Nicole Leigh Aaronson, MD, MBA, CPE, FACS, FAAP
Last Review Date: 2023 Mar 22
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