Eosinophilic Esophagitis FAQ’s

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How Many Eosinophils Indicate an EoE Diagnosis?
There are not supposed to be ANY eosinophils in your esophagus, but the standard number to qualify as an EoE diagnosis is usually >15 eosinophils per high-powered field.

Note: These 2 items (in addition to positive biopsy) must also be met to have a diagnosis of EoE from most doctors:

  1. Clinical symptoms of esophageal dysfunction (which is likely if you’re having a biopsy in the 1st place)
  2. Exclusion of other possible causes of esophageal eosinophilia (like PPI responsive eosinophilia or PPI-REE). If PPI treatment results in relief your doctor may not diagnose you with EoE.
Are EoE Symptoms Limited to the Esophagus?
You will hear many people talk about all kinds of symptoms related to EoE. These symptoms can be different between adults and children. That doesn’t mean EoE is the cause of those symptoms, or that they are even related. Strictly scientifically speaking, EoE in ADULTS is limited to the esophagus and the complications caused by eosinophils in the esophagus caused by an allergic reaction. In CHILDREN you see some stomach-related issues as well as what adults experience.

Stomach pains, intestinal issues, allergic reactions in places other than the esophagus may more likely be caused by other conditions. The medical-defined symptoms of EoE are on our “Symptoms of EoE” page. If you have other serious symptoms they should be looked at by a doctor.

Why Do They Call EoE "Asthma of the Esophagus"?
Asthma can be caused by eosinophils from allergies, which causes inflammation in the lungs. This is a severe form of asthma and it acts like Eosinophilic Esophagitis does in the esophagus.

An allergic reaction causes an infestation of eosinophil white blood cells (in both diseases), which causes inflammation and narrowing in the esophagus (EoE) and tightening in the lungs (Asthma). Because of the similar reaction, but in different places, EoE is the cousin of E-Asthma.

What Are Treatment Options for EoE?
There is no “cure” for EoE currently, and not even treatments approved by the FDA for the disease. Although that’s the case many people find relief (and clinical tests have proven effective) from what we call the “3 D’s”.

  1. Diet – Controlling what you eat to eliminate allergens causing eosinophils
  2. Drugs – Swallowed Corticosteroids have proven effective for many in reducing inflammation in the esophagus (Budesonide or Fluticasone)
  3. Dilation – The most immediate relief for swallowing issues (dysphagia) is to have your esophagus “stretched”. It’s a relatively safe procedure done as outpatient surgery

See our “treatments” page for more details on all of these.

Are Allergy Tests Trustworthy?
Allergy test for determining EoE triggers is not a perfect science. Determining EoE triggers is a difficult task, and just because you’re allergic to something doesn’t mean it’s a trigger for your EoE.

Because of this, the ONLY true way to know what to exclude to solve your EoE is “experience”. Experience meaning you have to SEE improvement by excluding the thing that you suspect, and prove that it’s the right thing. Allergy tests CAN help you identify these triggers, by identifying things that might be triggers. But the tests themselves are not enough to determine your triggers.

We recommend getting skin AND blood allergy tests and try excluding the highest identified allergens and work down to the mediums while you determine what helps you by paying close attention to your condition and any improvement after excluding possible allergens.

Can EoE Be Seasonal or From Non-Food Allergies?

Yes and Yes. Seasonal changes can make symptoms worse in some patients. Some patients may have environmental allergies instead of food allergies (or both). Some studies have even shown that symptoms are worse, including more food impactions during higher pollution seasons.