Total Eosinophilic Esophagitis Care Under One Roof

Eosinophilic esophagitis (EoE) is a chronic inflammatory condition of the digestive system where white blood cells fill the esophagus and make it difficult or even painful to eat. Children with EoE often have a hard time swallowing their food and might experience pain, nausea, acid reflux or vomiting. As a result, children with EoE may have problems gaining weight or refuse to eat. It’s even possible for food to get stuck on its way to the stomach, which can be a serious condition requiring emergency care.

At University Hospitals Rainbow Babies & Children’s, our pediatric digestive health specialists work closely with pediatric allergists, registered dietitians and pediatric nurses to diagnose and treat the condition in our EoE-dedicated clinic. This multidisciplinary approach helps foster ongoing collaborative communication between the physicians caring for your child ensuring a robust care plan aimed to reduce your trips to the hospital.

Expert Diagnosis of Eosinophilic Esophagitis

Symptoms of eosinophilic esophagitis can mimic those of acid reflux and are sometimes misdiagnosed. Being evaluated by our multidisciplinary team of pediatric gastroenterologists, pediatric allergists and registered dietitians will help ensure your child’s diagnosis is accurate.

Children with EoE commonly have other allergy conditions such as asthma, eczema, food allergies or seasonal allergies. We’ll review your child’s health record with you and perform a physical exam as part of the diagnostic process.

We may also perform other tests, including an endoscopy. An endoscopy is typically performed by inserting a small tube with a camera through the child’s mouth to examine the esophagus, stomach and small intestines. Our pediatric sedation experts safely sedate children under general anesthesia for this procedure. Sometimes a pH impedance test, a ring that’s inserted into the esophagus that measures how much and often a child experiences reflux for 24 hours, may also be used to rule out reflux.

Specialized Treatment for Eosinophilic Esophagitis

Eosinophilic esophagitis in children is most commonly treated with medication or diet. As an inflammatory condition, similar to asthma or eczema, anti-inflammatory drugs or steroids can be used for EoE treatment. Specialists may also prescribe medications that suppress or reduce acid in the digestive system.

Because food is often a trigger, many children are able to control their EoE symptoms simply by eliminating certain foods from their diet. Determining which food or foods are triggering inflammation can be tricky, however. Our nutrition specialists work closely with families to monitor each patient’s intake and reactions to help create a dietary plan to reduce triggers.

Identifying Food Triggers to Improve EoE Symptoms

At UH Rainbow Babies & Children’s Hospital specialized EoE Clinic, dietitians work with patients and their families to identify what’s triggering the reaction so it can be eliminated from the child’s diet. We begin by using the 4-Food Elimination Diet, which requires patients to stop eating milk, eggs, wheat and soy. After two to three months on the EoE diet, these common allergens are added back into the diet one by one to see which one produces a reaction. In some cases, children are also asked to eliminate fish and nuts as well, as these are the next most common allergens.

Beginning these restricted diets can be overwhelming and difficult, which is why our dietitians continue working with families to teach them about foods their children can eat. They also provide recipes and meal ideas to make the transition a little easier on the child as well those preparing his or her meals.