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Eosinophilic Esophagitis

When you’re living with heartburn that doesn’t quit, the problem might not be gastrointestinal reflux disease (GERD) or reflux. You may have a rare allergic condition known as eosinophilic esophagitis. Our allergists deliver effective care, including testing, treatments, and support so you can get lasting relief.

What is eosinophilic esophagitis (EoE)?

Your esophagus is part of your digestive system. When you swallow, food travels down the esophagus to the top part of your stomach.

Eosinophils are white blood cells that help you fight infections. A healthy esophagus has no eosinophils. With EoE, eosinophils are present in the esophagus and cause inflammation that triggers symptoms.

These symptoms include:

  • Difficulty swallowing
  • Chest pain
  • Heartburn

You may face a higher risk for this condition if you have food allergies, such as a soy or wheat allergy. Your risk also goes up if you have other allergic conditions, including asthma and eczema.

Eosinophilic esophagitis care at AHN: Why choose us?

Some people live with regular discomfort for years because EoE symptoms are so similar to GERD. At Allegheny Health Network (AHN), we put an end to the pain. Our complete approach to treating EoE includes getting you the right diagnosis and effective treatment.

Other highlights of our program include:

  • Highly skilled physicians: Our allergists completed additional training through fellowships. Their training allows us to deliver exceptional EoE care. And some of our doctors specialize in treating adults and others in treating children. This level of experience helps us tailor treatments to meet every patients’ needs. Meet our doctors.
  • Accurate diagnosis: We work alongside AHN digestive health doctors (gastroenterologists) to pinpoint the cause of your symptoms. We coordinate the tests you need to confirm or rule out an eosinophilic esophagitis diagnosis as quickly as possible. Learn more about gastroenterology.
  • Personalized care: We determine which foods are causing your symptoms using an elimination diet. Then, we provide detailed recommendations to help you avoid them. If you have additional questions, you can reach us using the secure messaging feature of our electronic medical record. Our personalized approach helps you achieve exceptional results.

Diagnosing eosinophilic esophagitis

We start by performing an evaluation that includes talking with you about your symptoms and performing a physical examination.

If we suspect EoE, we work with digestive health doctors to perform tests, such as:

  • Endoscopy: We check for eosinophils in your esophagus by sliding a narrow tube with a camera and light at the tip (endoscope) down your throat. You receive medication to help you sleep during the procedure.
  • Biopsy: During the endoscopy, we may take a tissue sample (biopsy) and examine it under a microscope. A biopsy helps us detect signs of EoE that can be easy to miss.

Proton pump inhibitor trial

To confirm an EoE diagnosis, we also put you on medications (proton pump inhibitors). This medication treats the symptoms of reflux but not EoE.

After you have taken all the medications, we perform an additional endoscopy and biopsy. If there are still eosinophils in your esophagus, the problem is EoE.

Treating eosinophilic esophagitis

There is no cure for this condition. But treatments can help keep symptoms under control.

Your options include:

Diet therapy (elimination diet)

Many people achieve lasting relief by avoiding foods that cause their EoE symptoms. We pinpoint the foods you are allergic to using an elimination diet.

You start the diet by temporarily eliminating all foods that are likely to trigger EoE symptoms. These foods include:

  • Eggs
  • Fish
  • Milk
  • Nuts
  • Soy
  • Wheat

After a brief waiting period, you start adding these foods back into your diet one-by-one. For example, you can start eating eggs again but must avoid other trigger foods until we confirm or rule out an egg allergy. If eosinophils reappear in your esophagus after re-introducing a particular food, that food is likely triggering your symptoms.

Permanently eliminating trigger foods from your diet helps you achieve lasting symptom relief. But it can be hard giving up foods you enjoy eating. For this reason, we offer recommendations and support, so you have the best chances for long term success.

Medications

If you are not able to eliminate trigger foods from your diet, your care may include one or more medications. Many people take steroids to reduce inflammation. But steroids can lose effectiveness over time meaning your symptoms may come back.

To keep symptoms at bay for as long as possible, your care may also include immunomodulators or biologic therapies. These medications disrupt the biologic processes that lead to EoE symptoms.

Contact us

Call (412) DOCTORS (412-362-8677) or request an appointment to learn more about AHN allergy and immunology services.