An Overview Look At Eosinophilic Esophagitis

Introduction

The gastrointestinal tract is part of the digestive system and its primary job is to make sure that the food is being consumed and digested to be turned into vitamins and nutrients for the body. The gastrointestinal tract also provides a protective layer in the intestinal permeability to prevent toxins and unwanted pathogens from leaking out of the gut and causing inflammation as well as other problems to the body. One of these pathogens is known as eosinophilic esophagitis and it can cause the gastrointestinal tract to be dysfunctional. In this article, we will be taking a look at what eosinophilic esophagitis is, its symptoms, and what kind of treatment to dampen its effects on the body. By referring patients to qualified and skilled providers who specialized in gastroenterology services. To that end, and when appropriate, we advise our patients to refer to our associated medical providers based on their examination. We find that education is the key to asking valuable questions to our providers. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

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What Is Eosinophilic Esophagitis?

In the digestive system, the esophagus’s main job is to make sure that when a person eats the food, the consumed food is traveling down to the stomach to be fully digested into nutrients for the body. When there are unwanted pathogens that start to cause damage to the esophagus, it is known as eosinophilic esophagitis. Research studies have shown that eosinophilic esophagitis is a chronic immune disease that is often characterized by a dense eosinophilic infiltrate into the esophagus. Some of the factors that can cause eosinophilic esophagitis to occur in the throat are:

• Genes
• Allergies
• Mast cells
• Acid reflux

Other research studies show that eosinophilic esophagitis causes eosinophil, a type of white blood cell to build up around the lining of the tube that connects the mouth to the esophagus. This build will cause injury or inflammation to the esophageal tissue, causing a person to have a difficult time swallowing their foods.

The Symptoms

Research studies have found that the pathophysiology of eosinophilic esophagitis has occurred as a result of immunogenic reactions to a variety of antigens that are most commonly found in the food that a person eats and the air they breathe. Since eosinophilic esophagitis is an immunogenic reaction, some of the symptoms can occur due to increased dietary exposure in infancy and youth all the way to adulthood. Other symptoms that can cause eosinophilic esophagitis to disrupt the esophagus can be the frequent use of antibiotics to alter the immune system and the gut flora. Other research studies have shown that the other symptoms that eosinophilic esophagitis causes in the throat and esophagus include:

• Heartburn
• Regurgitation
• Chest pains
• Trouble swallowing
• Acute GI infections trigger chronic systemic diseases via SIBO, inflammation, autoimmunity, etc.

Another symptom that eosinophilic esophagitis causes are an increased intestinal permeability introduces larger antigens resulting in increased eos & MCs, while also causing an increase in ileal lymphoid follicles and interaction with food antigens & bacteria in the body.

An Overview On Eosinophilic Esophagitis

Eosinophilic esophagitis is a chronic immune disease that causes inflammation in the lining of the throat and the esophagus (the stomach). Some of the symptoms that eosinophilic esophagitis causes are trouble swallowing, acute GI infections, and many more. The treatments that can dampen the progression of eosinophilic esophagitis include an elimination diet, immunotherapy, and medication.

How To Treat Eosinophilic Esophagitis

Since eosinophilic esophagitis is a chronic immune disease that causes inflammation in the lining of the throat and the esophagus. Research studies have found that numerous therapies for individuals that are suffering from eosinophilic esophagitis by including proton pump inhibitors, elimination diets, and topical corticosteroids that are effective and can reverse tissue fibrosis as well as decrease food impactions. Utilizing these therapeutic treatments to reverse the effects of eosinophilic esophagitis on individuals can help them recover and get their lives back together.

Elimination Diet

The elimination diet has been known to help individuals get their health back by eliminating certain foods that they might be sensitive to. For individuals that are suffering from eosinophilic esophagitis can use the elimination diet to help dampen the inflammatory effects that are affecting the throat and esophagus lining. Research studies have found that there 3 different approaches when it comes to treating eosinophilic esophagitis. The first approach is the elimination diet where the food allergens are removed and individuals have to consume an aminoacid-based formula to meet their nutritional needs. This will cause all the eosinophils to be eliminated and the inflammation to be resolved, while slowly re-introducing the foods one at a time to identify the individual’s food triggers.

The second approach is the 6-food elimination diet where individuals eliminate the 6 most common food allergens (milk, wheat, soy, egg, nuts, and fish) out of their system for 6 weeks and add them back in one at a time to identify the allergen that is causing eosinophilic esophagitis to react. The third and final approach is a skin patch test to identify the food allergen and eliminate them as part of the treatment for eosinophilic esophagitis.

Immunotherapy

Research studies have found that aeroallergens may have played a causative role in the development of eosinophilic esophagitis. For healthcare providers to utilize immunotherapy to dampen the effects of aeroallergens like pollen and dust mites that have entered the body and cause eosinophilic esophagitis to form. Individuals that are suffering from these allergens will find that immunotherapy can help them reduce their allergies and reduce the inflammation of the throat and esophagus. Another was that immunotherapy is beneficial for dampening the effects of eosinophilic esophagitis is that when it is injected into the body and downregulates the Th2 inflammation mediators that are causing the individual pain.

Conclusion

Therefore, eosinophilic esophagitis is a chronic immune disease that causes inflammation in the throat and esophagus lining. This immune disease is caused by allergens, genetics, and other factors that a person is suffering from, and the therapeutic treatments can help dampen the inflammatory effects. Utilizing the elimination diet and immunotherapy can help individuals find out what allergens are causing eosinophilic esophagitis to cause havoc in their bodies. Once they eliminate the source of their allergens, they can continue on their wellness journey pain-free.

References

Cianferoni, Antonella, and Jonathan M Spergel. “Immunotherapeutic Approaches for the Treatment of Eosinophilic Esophagitis.” Immunotherapy, U.S. National Library of Medicine, 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4697927/.

D’Alessandro, Alessandra, et al. “Eosinophilic Esophagitis: From Pathophysiology to Treatment.” World Journal of Gastrointestinal Pathophysiology, Baishideng Publishing Group Inc, 15 Nov. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4644879/.

Gonsalves, Nirmala P, and Seema S Aceves. “Diagnosis and Treatment of Eosinophilic Esophagitis.” The Journal of Allergy and Clinical Immunology, U.S. National Library of Medicine, Jan. 2020, pubmed.ncbi.nlm.nih.gov/31910983/.

Gonsalves, Nirmala. “Dietary Therapy for Eosinophilic Esophagitis.” Gastroenterology & Hepatology, Millennium Medical Publishing, Apr. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4836598/.

Medical Professional, Cleveland Clinic. “ESOINOPHILIC Esophagitis: Symptoms & Treatment.” Cleveland Clinic, 10 Mar. 2021, my.clevelandclinic.org/health/diseases/14321-eosinophilic-esophagitis.

Roussel, Jordan M., and Sudha Pandit. “Eosinophilic Esophagitis.” StatPearls [Internet]., U.S. National Library of Medicine, 14 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK459297/.

Staff, Mayo Clinic. “Eosinophilic Esophagitis.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 23 Sept. 2020, www.mayoclinic.org/diseases-conditions/eosinophilic-esophagitis/symptoms-causes/syc-20372197.

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