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Eosinophilic esophagitis (EoE) was once considered a rare disease, but is now becoming increasingly common. More than 470,000 people in the United States live with EoE, a chronic inflammatory disease of the esophagus that causes symptoms that can interfere with daily life.
A proactive approach to care can help manage EoE so you can enjoy your life without your illness affecting you.
Understanding EoE
EoE affects your esophagus, the tube that connects your mouth to your stomach. It occurs when your immune system floods this channel with white blood cells in response to certain allergens, an abnormal reaction known as type 2 inflammation.
Over time, white blood cells called eosinophils build up in the lining of your esophagus and cause inflammation, which can lead to EoE symptoms.
In adults, difficulty swallowing, also known as dysphagia, is the most common symptom of EoE.
Other symptoms of EoE include:
- Chest pain
- Food stuck in the throat after swallowing (impact)
- Foods that come up after swallowing (belching)
- acid
- Stomach pain
These symptoms can be constant or intermittent, but EoE is a chronic, lifelong condition and that means treating it is also a lifelong commitment.
Taking steps to proactively address your EoE, even if you don’t have symptoms, will help you better manage your disorder.
Why endoscopy is important
If you have EoE, your doctor probably used an endoscope to diagnose it. This long, thin tube with tools such as a lamp and a camera is used to examine the lining of the esophagus. Tissue samples may also be taken that contain evidence of your disease.
The name of the procedure in which your doctor uses an endoscope is called an endoscopy. Regular endoscopy, even if you feel well, is important to keep EoE under control.
“To evaluate EoE, three things need to be assessed: symptoms, endoscopies (the appearance of your esophagus), and histology (biopsy results),” said Evan Dellon, MD, director of the Center for Esophageal Diseases and Swallowing at the University of North Carolina School of Medicine. “This is because symptoms are not always a reliable indicator of how active EoE is.”
A patient may be doing well, but their esophagus may still show signs of EoE activity. A patient may have many symptoms even if the esophagus and biopsies appear normal.
Dellon suggests that people with EoE undergo endoscopy after any treatment change, whether starting something new or adjusting the current method.
“We also recommend performing endoscopies even when things are under control to ensure that treatments continue to work. However, the timing of these depends on the specifics of the patient’s condition,” Dellon said.
Know the signs of EoE
In addition to an endoscopy, you can keep your EoE under control by knowing how to tell if your treatment isn’t working.
“Usually when a treatment works well, symptoms should improve, as should the results of endoscopies and biopsies,” Dellon said.
“Yes [los síntomas mejoraron previamente]If the symptoms, such as eating leftovers or difficulty swallowing, reoccur, this is a sign that the treatment may not be working.
Flexibility when it comes to EEO
Everything changes in life, and this often includes the therapeutic needs of your EoE. A treatment that has always worked well for you may no longer work, or new treatment options may become available. Or you may decide to try a different therapy option to see what happens.
Life changes can also dictate how you manage your EoE. These could include:
- Financial or insurance changes
- Start your college education
- Moves
- a pregnancy
- An unpredictable schedule
“For example, someone who is studying might not want or be able to restrict their diet and choose an EoE drug,” Dellon said. “But after graduation and when things stabilize at work, that same person may want to stop taking medication and try food restriction treatment.”
Knowing that EoE or life can throw surprises at you may be helpful for you to adjust if you need to change treatment.
Manage EoE treatment with clear communication
During the different stages of your life with EoE, it is important to make it clear to your care team what is important to you. Communicating your treatment priorities can help you and your doctors create a plan that meets your needs.
“A key pillar of our current approach to addressing EoE is shared decision-making,” Dellon said. There are several safe and effective options for treating EoE, and which one is best for you depends largely on your preferences and priorities. Figuring out which treatment is best for you requires good communication between you and your doctor.
“Health care providers should provide sufficient information about treatment options so that a conversation can take place and the patient can make a decision.”
It’s also important to understand that treating your EoE may involve some sacrifices. For example, Dellon said patients must choose between using a drug that is cheap but less effective and one that costs more but may work better.
Read: How shared decisions can lead to better medical care >>
Stay on track
Although EoE is a chronic, lifelong condition, it can be controlled as long as you continue to treat it.
“Although there is currently no cure, several safe and effective treatments are available,” Dellon said. “But they need to be implemented in the long term because we know that EoE almost always recurs when treatments are stopped.”
This educational resource was created with support from Sanofi and Regeneron.
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