Allergic Esophogitis

[sukay]

Has anyone heard of have Allergic Esophogitis?
I will check around and see what I find, but I thought I would also try this board.

Thanks
Sukay

[zuzu8]

Hi Sukay-

For many years, this disease was thought to be a variant of reflux disease. It is now known to be a distinct condition and thought to be an allergic reaction, and it seems to occur more often in children.

Another name for it is eosinophilic esophagitis (EE). It's an allergic inflammatory reaction of the esophagus.

To distinguish between GERD and EE usually a biopsy is done. In EE high levels of eosinophils are detected in the esophagus only, and not other parts of the digestive tract.
Eosinophils are a type of white blood cell that are not normally found in the esophagus. High levels of eosinophils often indicate an allergic response.

(I have seasonal allergies and hayfever and my blood serum eosinophils are always high.)

Certain foods contribute to EE and skin-testing and patch testings can help identify which foods might be the offending culprits. The foods most associated with EE are cow's milk, soy, egg and wheat. Airborne allergens may also be a contributing factor.

Studies have revealed that symptoms from EE don't improve with aggressive acid blockage therapy that people usually take for GERD, but DO improve with an elimination diet or corticosteroid treatment.

EE can make digestion very painful. Here are some of the symptoms:

Abdominal pain, chest pain, choking, cramping, diarrhea, difficulty swallowing, failure to thrive, nausea, reflux not relieved by standard anti-flux therapy, skin rash or hives, vomiting, weight loss.

If anyone is being treated for GERD and their symptoms are not subsiding, they should discuss the possibility of EE with their doc.

Hope this helps a little.

zuzu xx

[sukay]

Thank you so much ZuZu for all of the information. I really appreciate it. I have searched a lot of places and came up empty handed. My son has been treated for what they also thought was acid reflux. All the meds never helped either. He had many EDG's, barium swallow tests, ph studies, etc. and sometimes he needed stretching of the esophogus, but most times he was wide open. It has been a long journey trying to figure out what is happening and the GI now thinks it may be allergic esophogitis. My son is now on Protonix and Flovent inhaler. If this doesn't work/improve his condition by Tuesday, we will have to have another EDG to see what's happening. If all goes well he will be scheduled for the EDG a month from now to see if the new meds are helping. Anything more you can tell me about this would be greatly appreciated. How do you start the process of finding out what the allergic culprit could be? Do I see a special doctor for that? How are you coping with this?

Thank you

Sukay

[quincy]

Hi sukay,

A big welcome :-D

I did read a bit of it and there seems to be some connection in people with asthma.

I can relate to some of the feelings after I eat certain foods..I get pains from certain foods, and a feeling of fullness - like something is stuck in there. It stays for a long while. I have asthma, and using my rescue inhaler helps somewhat, and Allegra will also help.

I'm also fighting some sort of throat/sinus thingie, so it's hard to distinguish if it's food, toothpaste (I react to many), cold, asthma, change in weather, allergy, reflux (which I've been having lately)... I'll wait till Monday to see if things improve, then call for an appointment to see my doc.

Sukay, they will probably do skin testing of foods to see if he's showing any reactions. You may also consider to keep a food diary of what he ingests (including vitamins, supplements, drinks...everything) for him until the appointment. Sometimes being the detective gives some insight.

Also, one can try eliminating foods for a few days, see if his symptoms change at all. There are some allergy elimination diets on the internet, eating only "non-offending foods"?, and then slowly adding foods that he normally eats to see if there are any reactions.

From what I read a while ago, four days seems to be the magic number. Cycling foods -- eg. eggs..have only every 4 days, not daily. Some people are OK with that, others may have a reacton.

It sounds very complicated, but if he sees an allergist, I'm sure it will all get sorted out.

It's great to see you here,
My best to you,
quincy

[zuzu8]

Sukay- How old is your son? Are you dealing with a pediatric gastroenterologist?

The GI doctor may indeed be onto something now.
The Children's Hospital Medical Center of Cincinnati has been doing a lot of work on this disease. (Among many other other places, now that it has been identified!)
In a study published in the January issue of The Journal of Clinical Investigation, Marc E. Rothenberg, M.D., Ph.D., has established a link between reflux/esophagitis and allergy -- not only food allergies but also environmental allergens such as pollens and molds. Apparently incidence of EE seems to have exploded in recent years mostly in children (but some adults too). Whether it's really on the rise, or whether the stats simply indicate that it's being IDENTIFIED properly now I'm not sure.

If a biopsy of your son's esophagus shows a large infiltration of eosinophils, a type of white blood cell not normally seen in the esophagus, into the gastrointestinal tract, then your doctor is right, and your son probably has EE. As I mentioned before, eosinophils in tissue are also a hallmark feature of an allergic response.
Children who develop esophagitis often have asthma. Does your son? (You mention he's on Flovent.) There seems to be some link between the two.

If the next EDG shows eosinophilic infiltration, it seems to me that your GI doc should refer you to the Dept. of Allergy/Immunology at a good Children's (or regular) Hospital. You need a specialist in allergy and immunology. You son would need allergy tests to determine if he is allergic to certain foods and/or airborne allergens. Based on the results, you are then in a good position to remove any offending allergens from his diet or environment (as much as possible, that is) and possibly begin him on a course of steroid therapy (if needed). They may be using other pharmaceutical therapies now as well.

As for my coping, I fortunately don't have reflux, nor any problems near what your poor son is going through.

Fortunately, if you find out that your son has specific allergies, then removing the "offenders" will probably have him on the road toward a true recovery.

zuzu xxx