Difference Between GERD and EoE

What is the Difference Between GERD and Eosinophilic Esophagitis? Well, A LOT

These 2 conditions are NOT the same thing, and are VERY different.

Gastroesophageal Reflux Disease or GERD is a digestive disorder that affects the lower esophageal sphincter (LES), the ring of muscle between the esophagus and stomach. The ring doesn’t do it’s job of keeping the acid in your stomach, and it allows the acid to consistently and frequently come up into your esophagus. This acid can cause irritation, pain, scarring and other discomforts. If you have GERD it does NOT mean you have EoE. When you have symptoms enough to see a GI and get an endoscopy, your doctor may find eosinophils in your esophagus. If so, he knows there’s a problem, BUT it may ONLY be GERD. That’s because acid from your stomach gets up into your esophagus and irritation occurs, eosinophils try to help in the healing process. The more acid, the more irritation, the more eosinophils.

At this point your doctor will prescribe PPIs (Protonix, Nexium, Prilosec, etc.) to immediately get the acid under control. Then you both will see how you do. If you have GERD ONLY, you will start to see improvement and the eosinophils will go into remission (because the inflammation was caused by the acid, and the acid is under control).

Eosinophilic Esophagitis or EoE, as described on this site, is a chronic immune system disease where you body produces a high amount of white blood cells called eosinophils isolated to your esophagus. The cause is an allergic reaction in your body to either food (most likely) or possibly inhaled allergens. For these people, even though acid may be under control and not getting into the esophagus, they will still have issues because the eosinophils are there because of an allergic reaction, not acid. These eosinophils cause inflammation and damage to your esophagus and, left untreated, will narrow your esophagus making it very difficult to swallow.

To break them down simply, GERD is where acid is allowed out of the stomach into the esophagus, causing heart burn and other issues, including build up of eosinophils in the esophagus. EoE is when your body has allergic reactions to allergens causing the eosinophils to consolidate in the esophagus.