- This 28 year old male was having years of swallowing difficulty.
- Careful inspection of the oesophagus reveals furrows, cracked lines and exudates – all in keeping with eosinophilic oesophagitis (EOE)
- In addition to classical symptoms of oesophageal dysfunction, and findings at endoscopy, oesophageal biopsies are required to confirm the diagnosis.
- It is generally recommended that at least 4 biopsies are taken from the distal oesophagus, as well as additional biopsies from either the mid or proximal oesophagus.
- Oesophageal biopsies from patients with EOE show an increased number of eosinophils. A threshold of at least 15 eosinophils per high power field (400x), in at least one biopsy specimen, is generally required for the diagnosis.
- Initial therapy for this allergic condition of the oesophagus often involves evaluation by an allergist or immunologist, and an exclusion diet where food allergies are detected.
- The use of ingested steroid puffers traditionally used for asthma can also be very effective in reducing the oesophageal inflammation.
- Proton Pump inhibitors are also often used, for a duration of 8 weeks or more.
- Sometimes, swallowing difficulties in this disorder are related to strictures of the oesophagus which may need endoscopic dilation for symptom relief.