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What is EOE and what role does IgE play in this food allergy?

Has your kiddo been diagnosed with eosinophilic esophagitis, also called EOE? If so, then you may be wondering what this really means. EOE is a food allergy disorder that causes inflammation of the esophagus. An eosinophil is a type of allergy cell, and the esophagus is the swallowing tube that connects the mouth to the stomach. Eosinophils are not normally found in the esophagus, so if they are present, EOE may be at play. While the underlying cause of this food allergy is still unclear, it is known that some foods can trigger this inflammation. In this post, we will discuss all things EOE: from symptoms to treatment options.

EOE is a food allergy that affects the esophagus.
EOE is a food allergy that affects the esophagus.

Who has EOE?

EOE is actually more common than you might think. The exact prevalence is unknown but is thought to be somewhere around 05.-1 cases/1000 persons. This food allergy affects both children and adults. Boys are affected more often than girls, and EOE usually develops in early childhood or adolescence. However, this food allergy can develop at any age.

What causes EOE?

The exact cause of EOE is unknown. However, it is thought to be a combination of genetic and environmental factors (also called epigenetics). There are some theories out there about what might trigger this food allergy condition, but nothing has been proven yet. Some possible triggers include:

  • An abnormal immune response to certain foods
  • Certain medications or medical conditions
  • Gastroesophageal reflux disease (GERD)
  • Allergies to airborne substances such as pollen or pet dander

EOE is often considered a “mixed IgE-and-non-IgE-mediated food allergy” because IgE may be present and may play some role. That said, this food allergy does not seem to be reliant to IgE for the condition to be present. It's unclear what role IgE plays in EOE.

If your kiddo has EOE so is avoiding milk, there are safe, yummy food options available in many grocery stores and restaurants.
If your kiddo has EOE so is avoiding milk, there are safe, yummy food options available in many grocery stores.

What are the symptoms of EOE?

The most common symptom of EOE is trouble swallowing. This may appear in a kiddo as having to drink a lot with eating. It may result in avoiding foods that are hard to swallow. Food can sometimes actually get stuck in the esophagus. Other symptoms may include:

  • Heartburn
  • Chest discomfort
  • Abdominal pain
  • Nausea
  • Vomiting
  • Weight loss
  • Fatigue

If you or your child is experiencing any of these symptoms, it's important to see a doctor.

How is EOE diagnosed?

EOE is diagnosed through a procedure called an EGD: esophagogastroduodenoscopy. This procedure involves having the child sedated then using a small camera to look at the esophagus. The camera geos thrugh the mouth, down the esophagus into the stomach, and can even peak into the first part of the small intestine. In addition to visualizing the areas, tiny biopsies can be taken. In EOE, biopsies are taken in multiple locations of this upper GI track. The kiddo then is gently awoken from sedation. Meanwhile, those biopsies are then sent to the laboratory, where they are examined under the microscope. If there are eosinophils in the biopsies, then EOE may be at play.

What is the treatment for EOE?

The good news is that EOE is treatable! One common treatment option is dietary modification, which involves avoiding trigger foods. This can be challenging as there is no test to determine which food is a trigger. Milk is a common trigger food for many kiddos and adults with EOE. Trigger foods may include:

  • Milk
  • Wheat
  • Egg
  • Soy and other legumes
  • Peanuts
  • Tree nuts
  • Fish
  • Shellfish

Another treatment is medication, which can help reduce the inflammation in the esophagus. If you or your kiddo has EOE, it's important to work with a doctor to find a treatment plan that works for you.

You've got this!

EOE can be a difficult condition, but with the right diagnosis and treatment plan, it is possible to live a normal, fantastic life. If you or your kiddo has EOE, the most important thing is to seek medical help from an allergist who is familiar with EOE and create a plan that works for your kiddo.

Families can still lead happy, wonderful lives while managing EOE.
Families can still lead happy, wonderful lives while managing EOE.

Thanks for reading this post “What is EOE and what role does IgE play in this food allergy?” Do you have any questions about food allergies? Reach out to me! And be sure to check out my other blog posts and podcast episodes about all things food allergy. Thanks for reading!
– Dr. Hoyt

P.S. Food allergy testing can be super confusing, so I've created this awesome ebook to clarify the facts from the fiction! Get your copy today!

food allergy testing ebook

Are you in need of an allergist in your area? Check out these allergist finder tools:

AAAAI Allergist Finder: https://allergist.aaaai.org/find/
ACAAI Allergist Finder: 
https://acaai.org/locate-an-allergist


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A note from Dr. Hoyt

I have talked about a non-profit…

Pam and I volunteer with the non-profit The Teal Schoolhouse. Its primary program is Code Ana. Code Ana equips schools for medical emergencies like anaphylaxis.

Code Ana’s Online Epinephrine Training Program helps support that goal. Through this program, you will educate yourself while you support this important mission!

A medical emergency response plan is important for everyone at any school. Code Ana's program Med-E Ready is a comprehensive approach to school-focused medical preparedness. This program guides schools through the process of creating a medical emergency response plan. A response team is also developed! This is one of the most important components of a school's food allergy policy!

Does your kiddo’s school have Code Ana?


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