Your gastrointestinal tract is approximately 30 feet long, and it runs from your mouth all the way to the anus! We know that celiac disease can impact any part of the digestive tract. But there is another disease that wreaks havoc on the GI tract as well, a condition called eosinophilic esophagitis or EoE.
The Gluten Free RN is explaining the fundamentals of eosinophilic esophagitis, from its characteristic inflammation of the esophagus and elevated eosinophils in the blood to the common symptoms of vomiting and upper abdominal pain. She walks us through the treatment for EoE, an elimination diet or steroid therapy.
Nadine speaks to the research exploring a possible connection between eosinophilic esophagitis and celiac disease, citing a paper that found a higher prevalence of EoE in children with celiac disease than the general population as well as the case study of a woman with both celiac disease and elevated eosinophils in her blood. Listen in for the Gluten Free RN’s insight on the best EoE clinics and physicians in the country and learn why further study is needed around EoE and celiac disease!
What’s Discussed: The fundamentals of eosinophilic esophagitis
Allergic response to dietary antigens Causes inflammation of esophagus, increased eosinophils in blood The benefits of unsedated transnasal endoscopy for children with EoE
Monitors esophageal mucosa without sedation Safer, faster and less costly Some common symptoms of eosinophilic esophagitis
Vomiting, difficulty swallowing, food stuck in throat Chest pain, heartburn, upper abdominal pain The condition of achalasia
Muscles of esophagus don’t work appropriately Causes spasms or constriction The treatment for EoE
Elimination diet (remove wheat, eggs, milk, soy, shellfish and seafood, peanuts and tree nuts) Topical or systemic steroids The potential increased prevalence of EoE in children with celiac disease
2015 paper found prevalence of 10.7% (much higher than general population) Other research articles argue no increased prevalence of EoE in CD The case study of a 30-year-old woman with celiac disease and elevated eosinophils
Presented with abdominal pain and distension, vomiting and frequent bowel movement Treated with IV hydrocortisone, but developed steroid induced psychosis Nadine’s insight on the best specialty clinics for EoE in the US
University of Colorado (Denver School of Medicine) Pennsylvania Dr. Glenn Furuta’s insight on the difficulty of diagnosing EoE
Relatively new disease, tendency to diagnose based on pathology report alone Elevated eosinophils also found in GERD, inflammatory bowel disease and celiac disease Special considerations for pediatric patients with EoE
Consultation with dietician Limited exposure to corticosteroids Attention to development of feeding skills Potential psychosocial, behavioral problems Resources: ‘Unsedated Transnasal Esophagoscopy for Monitoring Therapy in Pediatric Eosinophilic Esophagitis’ in Gastrointestinal Endoscopy
‘Eosinophilic Esophagitis Associated with Celiac Disease in Children’ in BMC Research Notes
‘Eosinophilic Gastrointestinal Disorder in Coeliac Disease: A Case Report and Review’ in Case Reports in Gastrointestinal Medicine
‘Eosinophilic Esophagitis in Children and Adults’ in Gastroenterology and Hepatology
‘The Association Between Celiac Disease and Eosinophilic Esophagitis in Children and Adults’ in BMC Gastroenterology
‘Eosinophils in Gastrointestinal Disorders’ in Immunology and Allergy Clinics of North America
‘2013 Update on Celiac Disease and Eosinophilic Esophagitis’ in Nutrients
‘Eosinophilic Esophagitis: New Insights in Pathogenesis and Therapy’ in the World Journal of Gastrointestinal Pharmacology and Therapeutics
‘Incidence and Prevalence of Eosinophilic Esophagitis in Children’ in the Journal o