Understanding Eosinophilic Esophagitis (EoE): how to recognize and treat it in kids

December 9, 2023

What's EoE? Eosinophilic Esophagitis, that's kinda common in kids (and adults)

Imagine having trouble swallowing your favorite foods, feeling like something is stuck in your throat, and experiencing tummy troubles frequently. These are some of the challenges kids with Eosinophilic Esophagitis (EoE) face. There's a lot to understand about EoE is, its causes, symptoms, diagnosis, treatment, and how you can help your kids manage it. Don't worry; we'll break down the complex medical terms to make it easy for you to understand. And we have more articles, videos and resources to give you a fuller knowledge.

What Is Eosinophilic Esophagitis?

Eosinophilic Esophagitis, or EoE for short, is a mouthful of a name for a condition that affects the esophagus, the tube connecting your mouth to your stomach. In EoE, the esophagus becomes inflamed and irritated. To understand this better, think of your esophagus as a tiny slide that helps to push your food into the stomach. When it's working correctly, food can move down smoothly. But with EoE, it's like trying to slide down a bumpy, rough slide and the pushing motion isn't as effective. This can cause many problems.

Causes of EoE

Doctors are still figuring out why EoE happens, but we believe it's related to an allergic reaction. Your immune system, which usually protects you from germs, might mistakenly think that certain foods or substances are dangerous. It then sends white blood cells called eosinophils to attack these "invaders" in your esophagus. This attack leads to inflammation and the symptoms of EoE.

Although we're not sure of the genetics involved, EoE is often present (and unrecognized) in one of the parents and other family members.

Symptoms of EoE

EoE can show up in different ways, and they may vary from person to person. Here are some common ones:

Difficulty swallowing: Kids with EoE often find it hard to swallow food or even liquids. It feels like something is stuck in their throat.
Food getting stuck: Sometimes, food can get stuck in the esophagus, sometimes causing intense discomfort. Other times, kids can clear that sensation by drinking with each bite.
Heartburn: Like adults with heartburn, kids with EoE might experience a burning sensation in their chest, since EoE can cause reflux
Vomiting: EoE can make you throw up, especially after eating.
Abdominal pain: Your child might experience bellyaches or discomfort.
Poor growth: EoE can affect your child's growth because it can be tough to eat enough when swallowing is a struggle.
Food refusal: Kids with EoE might avoid eating because they associate it with pain.

Diagnosing EoE

If you have these symptoms, your doctor will want to find out if you have EoE. They will start with a physical exam and ask about your symptoms. But the most important step is an endoscopy.

Endoscopy: This involves putting a tiny camera down your child's throat to look at your esophagus. It might sound scary, but your child will be asleep during the procedure, so he or she won't feel a thing. The doctor will likely take small tissue samples (biopsies) from the esophagus to check for eosinophils.

For many children, the symptoms can go away with treatment, but the EoE is still active. So, it's important to repeat the endoscopy to make sure the treatments are working so that scar tissue doesn't cause narrowing later.

Unfortunately, x-rays and other tests aren't as useful. Unfortunately, the usual allergy tests can't identify the problem, but some allergy tests can tell if certain foods are a problem for your child.

Treating EoE

Good news: EoE can be managed with proper treatment. Here are some common approaches:

Dietary changes: If certain foods trigger your EoE, your doctor might recommend avoiding them. This is called an elimination diet. Milk is often the most likely suspect, even if it doesn't show up on allergy tests.
Medications: Acid blockers can help reduce the inflammation in the esophagus. Steroids can also help reduce that inflammation. They can be swallowed as pills or taken as a liquid. Some people even use a special kind of steroid inhaler. But steroids also have some risks involved.
Advanced treatment: New medications to try to prevent the inflammation are available for children when dietary therapy and standard medications aren't enough.
Dilation: If the esophagus is too narrow due to scarring, a doctor might need to stretch it out in a procedure called dilation.
Allergy shots: If allergies are present along with your child's EoE, allergy shots (also known as immunotherapy) might help.

Managing EoE in your kids' everyday life

Living with EoE means making some changes to your lifestyle to stay healthy and avoid symptoms. Here are some tips:

Follow your child's treatment plan: Whether it's avoiding trigger foods, taking medications, or both, make sure your child follow the doctor's instructions carefully.
Help them stay calm: Stress and anxiety can make EoE symptoms worse. Have them practice relaxation techniques like deep breathing or yoga to stay calm.
Eat slowly: Make sure they take time when eating, and chew well. This can make swallowing easier. Take frequent sips of water, if that helps to get rid of the feeling that the food is getting stuck,
Stay hydrated: Encourage them to sip on water throughout the day to keep your esophagus moist and help with swallowing.
Talk to your friends and family: Let your loved ones know about your condition so they can support you and understand your dietary restrictions. Also let them know that EoE can run in families.
Keep a food diary: Have them write down what you eat and note any symptoms. This can help you and your doctor identify trigger foods.

Conclusion

Eosinophilic Esophagitis can be a challenging condition for kids to deal with, but with the right treatment and support, it can be managed. Remember, you're not alone. Many kids have EoE, and there are healthcare professionals who specialize in helping kids like yours. And there is a support / advocacy group you can join.