Eosinophilic esophagitis (EoE) can be best described as a condition that results in the inflammation of the esophagus. In 2015, the Cleveland Clinic Journal of Medicine defined this particular illness as a systemic condition and as a result of that finding, the condition is often misdiagnosed and treated for gastroesophageal reflux disease or GERD.
The misnomer can be attributed to white blood cells known as eosinophils that build up in the esophagus. This buildup of cells which aren’t meant to be there due mostly to allergies or irritation that cause inflammation at the beginning of the digestive system and make it hard to eat for example, because the muscles that allow for peristalsis no longer work as intended. Eosinophilic esophagitis is further complicated by the fact that it affects people of all ages, with children and teens more prone to experiencing abdominal pains and vomiting, and adults finding difficult to swallow, for example.
1. A Change In Diet
Food is a large contributor to how people suffering from eosinophilic esophagitis view and handle the disease. The type of food consumed plays a significant role in the level of discomfort that is felt. Studies from the division of gastroenterology and hepatology from the University of North Carolina, have found that a change in diet, involving the removal of certain foods from a person’s eating habits partially or completely can lead to improvements of up to 71% in suffers from the disease.
This is due, in part, to the leading theory surrounding eosinophilic esophagitis which is its causation via allergen. The use of skin and blood tests can determine what foods cause or aggravate EoE and therefore allow for such foods to be removed from a person’s diet completely. Another possible solution to be explored is the removal of all foods that could potentially cause problems and then introduce foods back into the diet up until the culprit is found.
2. The Right Use Of Medication
As things stand, there are no medications that have been approved by the Food and Drug Administration (FDA) to treat eosinophilic esophagitis. But there are a number of medications that are currently available that go a long way in improving the symptoms associated with the condition.
Medications like corticosteroids which are ideal for treating inflammation are great at minimizing the effects eosinophilic esophagitis has on the body. Although there a varied amounts of corticosteroids available to choose from, the manner in which they all work is very is similar, with large doses needed to control the inflamed area and once and only once the swelling has been kept under control.
There should be a reduction in the number of steroids taken in order to minimize the repercussions of the side effects, as well as maintain therapeutic levels required for the medication to be effective without being dangerous or harmful in any way.
3. Maintain A Healthy Weight
There are many benefits to staying in shape besides elusive muscles and figure around the waist. Simply put, having extra weight around the stomach adds pressure that promotes heartburn. Acid reflux is most likely to be the leading cause of exasperating the damaged or inflamed area in the esophagus. According to a 2006 study in the New England Journal of Medicine, found that small changes in a person’s body weight could increase the likelihood of acid reflux, which is a disease that finds the conditions created by Eosinophilic esophagitis, advantageous.
The study found a clear correlation between the body mass index (BMI) and the disease gastroesophageal reflux. People who were considered overweight by the index were twice as likely to develop the disease when compared to those who were not classified as overweight by the index. Furthermore, people considered overweight by the same measure were at triple the risk of developing acid reflux.
4. Avoid Things That Trigger Heartburn
EoE exhibits similar characteristics as GERD and as a result, is often misdiagnosed as this particular condition when in actual fact it’s another one entirely. The benefit to this, however, is that the fixes for one health condition can be applied to the other. Acid reflux or heartburn as it is commonly known is a commonality both conditions share which severely affects the lifestyle of people.
Due to its intensity, it’s often best to avoid certain foods altogether in order not to risk aggravating the inflamed and affected area. Eating slowly and taking your time between bites is one of the best ways to manage heartburn. As well as avoiding food that can act as triggers, include onions, peppermint, chocolate and caffeinated drinks just to name a few. It is also wise to eat at least two hours before going to bed in order to avoid increasing the chances of heartburn.
5. Sleeping Position
How you sleep makes a big difference in how the level of comfort you’ll experience throughout the night. People with EoE know all too well how the simple act of simply lying down can cause the probability of heartburn. Not only does this cause pain but it if unaddressed, could result in coughing, choking and even sleep apnea. Sleep is important and a lack of. Could result in serious implications both mentally and physically and therefore important that precautions be put in place to avoid discomfort throughout the night.
Sleeping on your back should be avoided at all costs, as this position vastly increases the chances of acid reflux which may aggravate an inflamed throat. Consuming smaller portions during dinner two to three hours in advance has shown to vastly improve the effects of a good night’s sleep. This along with other simple tips can vastly improve the quality and quantity of sleep obtained.
6. The Use Of Protein Inhibitors
Proton-pump inhibitors (PPI) were first introduced as a means of differentiating eosinophilic esophagitis from GERD, a disease that is extremely similar to the former. Studies conducted by Marie Cheng in 2011 were able to illustrate that the treatment does work on people diagnosed with eosinophilic esophagitis. The conclusion that can be drawn from this study and similar ones is that an individual’s response to PPI treatment can only be described as a transient phenomenon. As the results of the research conducted in 2011 have demonstrated completely.
But as more and more research is placed on the usage of PPI treatment, breakthroughs have surfaced with regard to long-term usage, considered to be from 3 to 5 years. That being said, the benefits of the usage of inhibitors include providing symptomatic relief from acid-induced pain and the subdual of gastric acid. Making it a viable option for people suffering from Eosinophilic esophagitis.
7. Environmental Factors To Look Out For
Almost nothing was known about EoE two decades ago. The biggest advancements of the disease have been in eliminating dietary triggers that exacerbate the effects of the illness. Climate, geography and season all play a role when it comes to you. Evidence of this can be found in a study published by Green, Cotton and Dellon from the University of North Carolina, back in 2016, was able to find a correlation between pollen and the number of eosinophils found in a biopsy and thus demonstrating proof of principle.
This study was further backed by a cross-sectional study conducted in Spain via an aeroallergen skin prick test. The findings of the experiment found that if a person was exposed to enough aeroallergens, the new onset of EoE could develop. It’s is therefore important for people to be mindful of their surroundings and try by all means to avoid places filled with dust, pollen, and other aeroallergens.
The following factor included cannot be changed but deserves a mention for the following reasons. Genetics plays a role that provides enough evidence to debate if eosinophilic esophagitis can be attributed to genetics or environmental factors. An article published in The Journal of Allergy & Clinical Immunology by Allen-Brady and colleagues, using 4000 Eosinophilic esophagitis cases of varying age, sex and place of birth along with matched controls. Was able to conclude that family members were at greater risk of contracting Eosinophilic esophagitis from each other, especially if those members were 18 years old and younger.
A small but significant number of cases involving Eosinophilic esophagitis were found to have unrelated spouses affected with Eosinophilic esophagitis. This finding, in particular, made it even harder to come to a conclusive decision on whether eosinophilic esophagitis can be attributed to the environment or genetics, as the finding can be accredited to either perspective.