Diagnosis of eosinophilic esophagitis
How will it be possible to diagnose eosinophilic esophagitis? What are the symptoms of this condition in different people?
Eosinophilic esophagitis (EVE) is a special form of inflammation of the food pipe (esophagus) that is not an infection and is not related to acid reflux (acid reflux disease, or GERD).
The disease takes its name from a special type of inflammatory cells (eosinophils) that increase significantly in the inner wall of the esophagus (mucosa).
For this reason, the occurrence of such inflammation is not clearly known, but due to the fact that eosinophils are often associated with allergies, allergies are suspected.
It may be an allergy to certain foods. Different people have different food allergies.
Eosinophilic esophagitis (EVE) is a relatively new disorder (mid-1990s).
What people get it?
Although eosinophilic esophagitis (EVE) can be seen at any age, young people (late teens, 20s and 30s) are more likely to suffer from it.
Most studies show that eosinophilic esophagitis (EVE) is more common in men than in women.
It seems that all races and ethnic groups are equally affected by this disorder. Also, there are no geographical restrictions around the world for this disorder.
risk factors
There are no known risk factors for eosinophilic esophagitis (EVE), but the following may be seen:
- History of allergy (atopy)
- Known food allergies
- Feeling of suffocation with food (compression of food)
- History of swallowing problems (dysphagia)
It is important to note that having a risk factor does not mean that a person will develop the disease. A risk factor increases the likelihood of developing a disease compared to a person without the risk factor. Some risk factors are more important than others.
Also, not having a risk factor does not mean that a person will not get the disease.
Causes of occurrence
The cause of eosinophilic esophagitis (EVE) is unknown.
It is most likely due to an allergic reaction to a certain type of food that occurs in the esophagus.
Signs and symptoms of eosinophilic esophagitis
Signs and symptoms of eosinophilic esophagitis (EVE) include:
- The most common symptom is difficulty swallowing (dysphagia).
- It is possible that the food gets stuck in the esophagus (compression of food) and the patient needs immediate help to get rid of it.
- Sometimes there may be difficulty swallowing food along with nasal allergies (sinusitis) and breathing problems (asthma).
- It is possible that eating less food due to swallowing disorder causes weight loss.
- Developmental disorder in children
- Esophageal stricture (stricture), especially in the middle of its length
Sometimes there are no symptoms at all. In such cases, the disease is diagnosed using partial endoscopic findings and pathological diagnosis in biopsy tissue. Also, the esophagus looks abnormal in the endoscopic examination.
diagnosis
The diagnosis of eosinophilic esophagitis (EVE) is made by a combination of clinical, endoscopic, and pathological findings.
Patients who have symptoms of swallowing disorder or compression of food are more tested.
These can include radiography (barium x-ray) to determine esophageal stricture.
Endoscopic examination of the esophagus shows one or more of the following abnormalities:
- the dimples
- grooves
- tightness
- White spots
- Plaque
When a biopsy sample from the esophagus is examined by a pathologist under a microscope, it shows the following abnormalities.
The pathologist will encounter a dramatic increase in eosinophils (> 20/HPF), eosinophils, including eosinophil clusters or masses (microabscesses) are more towards the lumen, and hyperplasia of the basal region is noted.
It is possible that many clinical diseases have similar signs and symptoms. It is possible that your doctor will perform additional tests to rule out the possibility of other clinical diseases to reach a definitive diagnosis.
Possible side effects
Complications from eosinophilic esophagitis (EVE) can include:
Throat congestion due to compressed food can be an emergency that requires endoscopy to remove it.
There is also a possibility of expansion (expansion or elongation) of the narrowed (narrow) part.
Treatment of eosinophilic esophagitis
Treatment of eosinophilic esophagitis (EVE) includes dietary changes (avoiding or eliminating certain foods), and/or using topical steroids.
prevention
Preventive measures to prevent eosinophilic esophagitis include:
- Following a diet that is effective.
- Finding a way to treat allergies
Prognosis
Most patients with eosinophilic esophagitis (EVE) are treated with diet and topical steroids.
A small number of patients who are not treated with these treatments require additional treatments, including dilation of the narrow esophagus.
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