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Overview
嗜酸性食管炎(称为EoE)是一个disorder of the esophagus, the tube that connects your mouth to your stomach. EoE is increasingly recognized as a major cause of swallowing difficulties in children and adults. It affects about one in 2,000 people.
一种慢性The immune system is a collection of cells and proteins that works to protect the body from potentially harmful, infectious microorganisms (microscopic life-forms), such as bacteria, viruses and fungi. The immune system plays a role in the control of cancer and other diseases, but also is the culprit in the phenomena of allergies, hypersensitivity and the rejection of transplanted organs, tissues and medical implants." rel="tooltip">immune systemdisease, EoE can be triggered by a foodAllergies are inappropriate or exaggerated reactions of the immune system to substances that, in the majority of people, cause no symptoms. Symptoms of the allergic diseases may be caused by exposure of the skin to a chemical, of the respiratory system to particles of dust or pollen (or other substances), or of the stomach and intestines to a particular food." rel="tooltip">allergy, acid reflux – when acid backs up from your stomach into your esophagus – or an airborne (seasonal) allergy. It causes your immune system to overreact, prompting a large number of white blood cells called eosinophils to collect in your esophagus. As a result, your esophagus becomes inflamed.
The condition often gets worse over time and can interfere with your quality of life. Although there is no cure, treatment is available.
Symptoms
The main symptom of EoE is difficult swallowing. Other symptoms vary by age and can include:
- Irritability
- Problems with feeding
- Poor weight gain and growth among infants and toddlers
- Reflux, when acid from the stomach backs up into the esophagus, causing a burning sensation or chest pain
- Regurgitation, when food backs up into the mouth from the esophagus and stomach
- Vomiting
- Stomach pain
- Chest pain in teens and adults
People with EoE may feel the need to drink a lot of fluids to help swallow food and may be unable to finish a meal because they feel full halfway through. In some cases, solid food can get stuck in the narrowed esophagus, potentially prompting a trip to the emergency room.
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如果你的儿子或女儿的结构ggling with eosinophilic esophagitis, take control and consult an allergist today.
Causes
Experts believe both genetic and environmental factors play a role in the development of EoE. About half of people with EoE also have seasonal allergies orAsthma is a chronic, inflammatory lung disease characterized by recurrent breathing problems. People with asthma have acute episodes where the air passages in their lungs get narrower, and breathing becomes more difficult. Sometimes episodes of asthma are triggered by allergens, although infection, exercise, cold air and other factors are also important triggers." rel="tooltip">asthma. Some notice their EoE symptoms get worse during the spring and summer when they experience seasonal allergies. Others may have food allergies orAn inflammation of the skin, usually causing itching and sometimes accompanied by crusting, scaling or blisters. A type of eczema often made worse by allergen exposure is termed "atopic dermatitis."" rel="tooltip">eczema(atopic dermatitis), a skin disease that causes an itchy rash. The foods that most commonly cause an allergic reaction leading to EoE include milk, eggs, wheat, soy, peanuts or tree nuts and fish or shellfish. You may have a combination of allergies that increase the risk of EoE. For example, although it is rare for pollen allergies alone to cause EoE, about one in four people who have food allergy-induced EoE notice a seasonal variation in their symptoms.Diagnosis
Because symptoms of EoE are similar to gastroesophageal reflux disease (GERD) it is important to be assessed by both an allergist and a gastroenterologist to get an accurate diagnosis. Your doctor will take a complete health history and may recommend food allergy testing and an/or an upper endoscopy to check the esophagus forInflammation is the redness, swelling, heat and pain in a tissue due to chemical or physical injury, or to infection. It is a characteristic of allergic reactions in the nose, lungs, and skin." rel="tooltip">inflammation. For an endoscopy, the doctor will insert a tube through your mouth into your esophagus while you are sedated and may take a biopsy (a tiny bit of tissue) from the lining of your esophagus to confirm the EoE diagnosis.Treatment
Your doctor can help you find a treatment plan that works for you. The treatment prescribed will depend on what’s triggering your EoE and the severity of your symptoms. Treatments may include:- Topical steroids: Topical steroids can be liquid medication you swallow, such as budesonide or inhaled and swallowed, such as fluticasone. Though not approved for EoE by the U.S. Food and Drug Administration (FDA), they are commonly prescribed. These medications may help calm the inflammation in the esophagus.
- Proton pump inhibitors (PPI): PPIs are oral medications that reduce the acid in your stomach. Although they are not approved for EoE by the FDA, they are commonly prescribed.
- Diet therapy: The allergist may recommend you eliminate all foods that are common triggers of EoE, including tree nuts, peanuts, fish and shellfish, wheat, dairy products, eggs and soy products. If tests show you have specific food allergies, your allergist may recommend you stop eating those foods to see if your symptoms improve. Another possible treatment is the elemental diet, a special liquid or powder nutrition replacement taken for up to six weeks to allow your esophagus time to heal.
- Esophageal dilatation: If your esophagus gets too narrow, your doctor may recommend stretching it. This can be done during the endoscopy. A balloon is inserted through the tube placed in your throat and blown up to stretch the area that has become narrow.
- Biologic therapy: Biologics are newer, targeted therapies that reduce inflammation. Biologics are provided by injection or IV (intravenous). The FDA approved dupilumab (Dupixent®) in 2022 as a treatment for EoE. Benralizumab (Fasenra®), another biologic, has orphan drug designation. The FDA may approve other biologics for EoE in the near future.
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Content updated 5/23/22
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