Eosinophilic Oesophagitis (EoE): When Food Gets Stuck

Common symptoms of include:

• Difficulty swallowing, or the sensation that food is travelling slowly or getting "stuck" on the way down.

• Food Impaction: A medical emergency where food becomes firmly lodged in the oesophagus and cannot be cleared.

• Chest Pain: Often centrally located and not always related to heartburn.

• Reflux-like Symptoms: Heartburn or regurgitation that does not respond to standard anti-acid medications.

EoE cannot be diagnosed by symptoms alone, as they often overlap with GORD (Gastro Oesophageal Reflux Disease). A Gastroscopy is essential for a definitive diagnosis and look for complications such as narrowing (or stenosis). At Gastroscopy, tiny samples (biopsies) are obtained from different levels of the oesophagus to count the number of eosinophils under a microscope.

The goal of treatment is to reduce inflammation, prevent food impaction, and stop the formation of narrowing (stenosis) in the oesophagus.

1. Dietary Therapy

Since EoE is often triggered by food, dietary changes can be highly effective.

• Elimination Diets: This involves removing common triggers (such as dairy, wheat, eggs, or soy) and then systematically reintroducing them to identify the specific cause.

• Working with Specialist GI Dieticians can guide you through this process to ensure your nutritional needs are met while identifying your triggers.

2. Medical Therapy

• Proton Pump Inhibitors (PPIs): Many patients respond well to high-dose PPIs, which can reduce inflammation even if acid is not the primary cause.

• Topical Steroids: Swallowed (not inhaled) steroids, such as Fluticasone or budesonide are used to coat the oesophageal lining and dampen the allergic response.

3. Endoscopic Dilation

If long-term inflammation has caused the oesophagus to narrow (a stricture), dilation may be needed, which can be performed at Gastroscopy. This involves gently stretching the narrowed area to make swallowing easier and safer.