From the Guidelines
Symptoms of eosinophilic esophagitis (EE) include dysphagia, food impaction, abdominal pain, and vomiting, with a significant impact on quality of life, as defined by the British Society of Gastroenterology and British Society of Paediatric Gastroenterology, Hepatology and Nutrition joint consensus guidelines 1. The symptoms of EE can vary between adults and children, with adults typically presenting with dysphagia and food impaction, while children may show feeding difficulties, abdominal pain, and vomiting 1. Some key points to consider when diagnosing EE include:
- Dysphagia and food impaction are common symptoms in adults
- Feeding problems, abdominal pain, and vomiting are common symptoms in children
- Oesophageal histology showing a peak eosinophil count of ≥15 eosinophils/high power field (or ≥15 eosinophils/0.3 mm² or >60 eosinophils/mm²) is diagnostic of EE 1 The chronic nature of EE means symptoms often persist or recur without proper treatment, and many patients develop coping behaviors like eating slowly, cutting food into small pieces, or avoiding certain foods altogether. It is essential to consider EE in the differential diagnosis of patients presenting with these symptoms, as prompt diagnosis and treatment can significantly improve quality of life and prevent long-term complications, as recommended by the joint consensus guidelines 1.
From the Research
Symptoms of Eosinophilic Esophagitis (EE)
- Dysphagia (difficulty swallowing) is a common symptom of EE, often described as a feeling of food getting stuck in the throat 2, 3, 4, 5, 6
- Food impaction, where food becomes lodged in the esophagus, is another frequent symptom 2, 3, 4, 5, 6
- Esophageal strictures, which can lead to narrowing of the esophagus, may cause symptoms such as dysphagia and food impaction 2, 3, 4, 5
- Gastroesophageal reflux-like symptoms, such as chest pain and vomiting, may also be present in some cases 3, 4, 6
- Other symptoms, including feeding difficulties and abdominal pain, have been reported in patients with EE 3, 6
Clinical Presentation
- EE can present with a range of symptoms, from mild to severe, and may be chronic or intermittent 2, 3, 4, 5, 6
- The disease is often associated with other atopic conditions, such as allergic rhinitis, bronchial asthma, and eczema 2, 3
- EE can affect individuals of all ages, although it is more common in adult White men and children with a history of atopy 2, 3, 4, 6
Diagnostic Criteria
- A diagnosis of EE is typically made based on a combination of clinical symptoms and histologic evidence of eosinophil-predominant inflammation of the esophageal epithelium 2, 3, 4, 5, 6
- Endoscopy with biopsy is often used to confirm the diagnosis, with a peak concentration of >15 eosinophils per high power field considered diagnostic 2, 3, 4, 5, 6