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Eosinophilic Esophagitis


Presentation

  • Adults and children with eosinophilic esophagitis (EoE) have distinct clinical and endoscopic presentations.[ncbi.nlm.nih.gov]
Weight Loss
  • This case report presents a 13-year-old boy referred to the Department of Paediatric Dentistry, Women's and Children's Hospital, Adelaide, South Australia, Australia, with a 5-week history of severe oral ulcerations and significant weight loss of unknown[ncbi.nlm.nih.gov]
  • Can be associated with weight loss, heartburn, regurgitation (especially with lying flat), and aspiration pneumonias. Eosinophilia is thought to be due to a reactive process from stasis of esophageal contents.[online.epocrates.com]
  • Call 911 Call 911 if you have: Food stuck in your throat Difficulty breathing or talking Chest pain When to call the healthcare provider Call your healthcare provider if you have EoE and notice any of these symptoms: Increasing weight loss Increase in[urmc.rochester.edu]
  • The degree of stricture and the extent of the blockage may limit food intake and lead to weight loss.[northshore.org]
Feeding Difficulties
  • EoE is a chronic immune-mediated disorder of the esophagus, which may present as dysphagia, food impaction, heartburn, vomiting, abdominal pain, feeding difficulties, or failure to thrive.[ncbi.nlm.nih.gov]
  • Unexplained feeding difficulties, vomiting, and solid-food dysphagia, especially in boys with atopy, supports the possibility of having EoE.[cfp.ca]
  • In addition, young children with EoE may present with feeding difficulties and poor weight gain.[en.wikipedia.org]
  • Children may present with feeding difficulties, abdominal pain, vomiting and a burning sensation in the stomach whereas adults typically present with difficulty swallowing and/or food obstruction.[allerg.qc.ca]
Dysphagia
  • Dysphagia is a common symptom in these patients, usually related to stricture, dysmotility or peptic esophagitis.[ncbi.nlm.nih.gov]
Vomiting
  • However, Boerhaave's syndrome or transmural perforation of the organ resulting from vomiting induced to dislodge impacted food has rarely been reported.[ncbi.nlm.nih.gov]
  • EoE often presents with difficulty swallowing, food impaction, regurgitation or vomiting, and decreased appetite. In addition, young children with EoE may present with feeding difficulties and poor weight gain.[en.wikipedia.org]
Abdominal Pain
  • Older children with GERD may present with regurgitation, heartburn, chest discomfort, dysphagia, abdominal pain, vomiting, poor appetite, or poor weight gain.[ncbi.nlm.nih.gov]
Nausea
  • EoE is a TH-2 driven, allergen-mediated disease which causes esophageal eosinophilia and presents with symptoms of nausea, feeding intolerance, regurgitation, and dysphagia.[ncbi.nlm.nih.gov]
  • Rather, the reactions can be nausea, vomiting, diarrhea and can occur days later. Animal studies show that pollens can also cause the condition.[azsneeze.com]
  • In children, symptoms of EoE include abdominal pain, nausea, vomiting, anorexia and dysphagia.[clinicaladvisor.com]
  • Symptoms of EoE include nausea, vomiting, and abdominal pain after eating. A person may also have symptoms that resemble acid reflux from the stomach.[aarda.org]
Failure to Thrive
  • A 16-month-old boy presented with failure to thrive despite sufficient caloric intake, hypersalivation, abdominal pain, chronic diarrhea and blepharitis. An eosinophilic esophagitis (EoE) was diagnosed by esophageal biopsy.[ncbi.nlm.nih.gov]
  • In infants, this disease may be associated with failure to thrive. In some situations, avoiding certain food allergens will be an effective treatment for EoE. (Visited 13,282 times, 17 visits today) « Back to Glossary Index[aarda.org]
  • In infants or young children, a refusal to eat to eat may be seen as well as failure to thrive. In school-aged children, abdominal pain, difficulty swallowing or vomiting may be observed.[globalgenes.org]
Hypersalivation
  • A 16-month-old boy presented with failure to thrive despite sufficient caloric intake, hypersalivation, abdominal pain, chronic diarrhea and blepharitis. An eosinophilic esophagitis (EoE) was diagnosed by esophageal biopsy.[ncbi.nlm.nih.gov]
Chest Pain
  • Approximately half of the patients complain about spontaneously occurring chest pain. However, some patients with eosinophilic esophagitis suffer from, in addition to the described symptoms, exercise-induced chest pain.[ncbi.nlm.nih.gov]
  • Majority patients with chest pain and deep mucosal tears did not require hospitalization and symptoms were self-limiting[doi.org]
Blepharitis
  • A 16-month-old boy presented with failure to thrive despite sufficient caloric intake, hypersalivation, abdominal pain, chronic diarrhea and blepharitis. An eosinophilic esophagitis (EoE) was diagnosed by esophageal biopsy.[ncbi.nlm.nih.gov]
Behavior Problem
  • Unrecognized gastrointestinal disorders may contribute to the behavioral problems in non-verbal patients, but they are often overlooked since the clinical symptoms are nonspecific.[ncbi.nlm.nih.gov]

Workup

  • […] treatments for eosinophilic esophagitis, including topical steroids and/or dietary therapy, in patients who did not undergo a proton pump inhibitor trial prior to diagnosis or who had an alternative diagnosis to eosinophilic esophagitis upon completed workup[ncbi.nlm.nih.gov]
  • Crohn’s disease Workup It is important to review the growth and development of the child in order to evaluate the severity of feeding intolerance. If there is a high clinical suspicion of EoE, an upper endoscopy with biopsies is required.[pedclerk.bsd.uchicago.edu]
HLA-DQ2
  • The implicated genes at the HLA-DQ2 and/or DQ8 gene loci are found in 95 percent of people with celiac disease [ 23 – 25 ].[doi.org]

Treatment

  • The varied response to treatments highlights the heterogeneity of EoE and the need for new treatment strategies.[ncbi.nlm.nih.gov]

Prognosis

  • An accurate view of the natural history of EoE is central to discussions with patients regarding disease prognosis and decisions about long-term use of medical, endoscopic, and diet therapies.[ncbi.nlm.nih.gov]
  • When treated effectively, the prognosis for people with eosinophilic esophagitis is excellent.[nyp.org]
  • Prognosis EoE is a chronic disorder with persistence of symptoms and inflammation over years.[orpha.net]
  • WHAT IS THE PROGNOSIS? People still study the natural history of Eosinophilic Esophagitis. It is a chronic disease that requires long term follow-up.[dhat.com]

Etiology

  • In the past two decades, the etiology of EoE has been and is continuing to be revealed.[ncbi.nlm.nih.gov]

Epidemiology

  • This case study discusses the epidemiology of eosinophilic esophagitis and the proper procedures for diagnosis, referral, and management using the dietary restrictions and pharmacologic treatment included in the clinical recommendations issued by the[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • The review further concentrates on the pathophysiology of the disease with particular focus on the important concepts of the molecular etiology of EoE including barrier dysfunction and allergic hypersensitivity.[ncbi.nlm.nih.gov]

Prevention

  • As EoE cannot be cured yet, treatment goals are suppression of disease activity and symptoms as well as the prevention of progression to a more severe disease phenotype.[ncbi.nlm.nih.gov]
  • Furthermore, the early administration of a drug that blocks the effect of MIF prevented the eosinophils accumulation in the esophagus and the development of esophagitis in treated mice.[news-medical.net]

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