Is It Heartburn or Something More? Eosinophilic Esophagitis Symptoms You Should Know
Key takeaways:
Eosinophilic esophagitis is an allergic condition. It causes inflammation in the esophagus.
The symptoms of eosinophilic esophagitis overlap with gastrointestinal reflux disease. They include heartburn, abdominal pain, and difficulty swallowing.
Treatment for eosinophilic esophagitis includes avoiding certain foods, steroids, and dupilumab (Dupixent).
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Eosinophilic esophagitis is an allergic condition that can affect infants, children, and adults. Eosinophilic esophagitis shares many symptoms with gastrointestinal reflux disease (GERD). GERD is far more common than eosinophilic esophagitis. It’s common for people to mistakenly blame GERD for their symptoms and not realize they have eosinophilic esophagitis.
If you’ve been wondering whether your heartburn could be a sign of something other than GERD, here’s what you need to know about eosinophilic esophagitis symptoms.
What is eosinophilic esophagitis?
Eosinophilic esophagitis is an allergic condition that affects the esophagus. People with eosinophilic esophagitis develop an immune system response to certain foods. When they eat a trigger food, for example, a type of white blood cell known as eosinophils activate and cause inflammation inside the esophagus.
This inflammation leads to classic eosinophilic esophagitis symptoms. And over time, the inflammation can cause scarring in the esophagus, also called esophageal strictures.
Esophageal strictures make it hard to swallow food and liquids. Strictures and inflammation also increase a person’s risk of developing food impaction. This is a painful and serious situation where food gets stuck in the esophagus. The food has to be removed right away, usually via endoscopy, to prevent the esophagus from tearing.
What are the symptoms of eosinophilic esophagitis?
The symptoms of eosinophilic esophagitis vary depending on a person’s age. Adults with eosinophilic esophagitis have different symptoms than children and infants.
The most common symptoms of eosinophilic esophagitis in infants and children are:
Difficulty feeding
Nausea
Vomiting
Abdominal pain
Trouble gaining weight or growing
Adults usually don’t have trouble with weight maintenance. But they do experience:
Heartburn
Stomach pain
Chest pain
Difficulty swallowing
Food impaction, when food gets stuck in your esophagus
Poor growth is a serious problem in infants and children. So they often get diagnosed with eosinophilic esophagitis quickly.
But eosinophilic esophagitis symptoms in adults aren’t very specific. There are many conditions that can cause heartburn, pain, nausea, and vomiting. Often, these conditions are more common than eosinophilic esophagitis.
How do you know if your heartburn is caused by eosinophilic esophagitis?
It can be hard to tell if your heartburn and other GERD symptoms are from GERD or eosinophilic esophagitis. You probably won’t be able to tell just based on how you feel. The only way to diagnose eosinophilic esophagitis is with an upper endoscopy. During this test, a gastroenterologist can look for inflammation inside your esophagus. They can also take samples from your esophagus to look for eosinophils.
It can be hard to know if it’s time to see a specialist. But there are some warning signs that mean it’s time to get that specialized help:
You experience food impaction. People with eosinophilic esophagitis are at higher risk of getting food stuck in the esophagus. Talk with a gastroenterologist about testing for eosinophilic esophagitis if you’ve experienced food impaction.
Your symptoms are getting worse. People with GERD typically experience a burning sensation and chest pain. They may have some discomfort with swallowing. But they don’t usually experience pain or spasms with swallowing. Talk with a gastroenterologist if you’ve noticed that your symptoms are getting worse and moving beyond heartburn. These could be symptoms of eosinophilic esophagitis.
Treatment for GERD isn’t helping. Proton pump inhibitors (PPIs) and other reflux medications help relieve heartburn and other GERD symptoms. But these treatments aren’t enough to stop inflammation from eosinophilic esophagitis. Talk with a gastroenterologist if your symptoms continue or get worse while taking these medications.
How do you get rid of eosinophilic esophagitis?
There’s no cure for eosinophilic esophagitis. But there’s treatment that can control inflammation and ease symptoms. Treatments for eosinophilic esophagitis include:
Medications: Steroids can control inflammation from eosinophilic esophagitis. They’re taken by mouth. Dupilumab (Dupixent) is a monoclonal antibody that can help treat eosinophilic esophagitis, too.
Diet changes: People with eosinophilic esophagitis need to avoid their food triggers. This means they have to stop eating certain foods. Babies may need to drink special elemental formulas. These formulas are less likely to trigger allergic responses.
The bottom line
Eosinophilic esophagitis is an allergic condition that causes inflammation in the esophagus. It causes symptoms like heartburn, nausea, and vomiting. Many adults mistake eosinophilic esophagitis for heartburn or GERD. Talk with your primary care professional or a gastroenterologist if you experience worsening GERD symptoms or food impaction. These could be signs that you need to be checked for eosinophilic esophagitis.
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References
AGA GI Patient Center. (n.d.). Eosinophilic esophagitis (EoE). American Gastroenterological Association.
Desai, J. P., et al. (2023). Esophageal stricture. StatPearls.
Furuta, G. T., et al. (2015). Eosinophilic esophagitis. New England Journal of Medicine.
Gonsalves, N., et al. (2021). Eosinophilic esophagitis. American College of Gastroenterology.
Hirano, I., et al. (2020). Guideline: Management of eosinophilic esophagitis (EoE). American Gastroenterological Association.
Lenz, C. J., et al. (2019). Food impaction: Etiology over 35 years and association with eosinophilic esophagitis. Diseases of the Esophagus.
