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Eosinophilic Esophagitis


OBXMom

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My 8 year old with celiac disease has been having a tough time with a nauseous feeling in this throat after eating, and a feeling that food is getting stuck. This started after he was taken off of the prevacid he took for years for reflux and also his zyrtec to better track allergic symptoms during his elimination diet. The problem began when we added soy, then just got worse and worse despite discontinuing soy. His doctor says that he may have EE, and that if his symptoms don't improve next week after resuming his meds and adding pepcid complete, to come in.

My question is: How important is it to know whether or not it is EE? I think he is improving on his medications, but I am still worried that he might have it. It is only diagnosed by a biopsy, so I am wondering how important the diagnosis is.

- Jane


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Nancym Enthusiast

I can't answer your questions but Dr. Scot Lewey writes alot about this. You might check him out. Open Original Shared Link

curlyfries Contributor

This doesn't really answer your question, as I don't know anything about EE, but I have lots of experience with reflux. Before I was diagnosed with GERD, I had the feeling that something was constantly stuck in my throat. This was from the irritation that the reflux had caused. I never really felt nauseous, but it did make me gag sometimes. Since going gluten-free, I haven't needed the medicine---until recently. And I think that is simply because I have recently eaten something that has caused a lot of acid to build up. I got heartburn, a sore throat, and that same "lump in the throat" feeling. I eliminated some things (citrus) and the heartburn is gone, the sore throat is getting better, but I know it will take more healing time for that lump feeling to go away. Perhaps going back on his meds will be all he needs.

Hopefully someone else can answer your question. :D

Lisa

OBXMom Explorer

Nancy, I found some great information through the link you posted, and am posting Dr. Lewey's response to this question below in case anyone else is ever searching for the same answer.

Lisa, thank you, too, it is good to hear that regular GERD can cause that same stuck-food in the throat. Hope you continue to feel better.

From article by Dr. Lewey:

"Why is it important to diagnose eosinophilic esophagitis and distinguish it from acid reflux esophagitis?

Acid reflux esophagitis usually responds to acid blocker medications like histamine 2 blockers ranitidine (Zantac), cimetidine (Tagamet), famotidine (Pepcid) and proton pump inhibitors like omeprazole (Prilosec) or esomeprazole (Nexium) whereas eosinophilic esophagitis often does not get better with these medications. Acid reflux injury to the esophagus can result in narrowing or constriction of the lower esophagus causing a food sticking sensation. This can be treated by a stretching of the constriction known as esophageal dilation that is usually safe and highly effective. Eosinophilic esophagitis also may result in constrictions of the esophagus but the stricture or rings are usually multiple, located higher in the esophagus and carry a high risk of tearing or puncturing the esophagus if dilation is attempted before treatment with steroids. There does not seem to be an association of cancer of the esophagus with eosinophilic esophagitis like there is with acid reflux. However, eosinophilic esophagitis can be chronic and difficult to treat."

happygirl Collaborator

www.apfed.org

I'd say its extremely important to have a knowledgable doctor about it and an accurate diagnosis.

pixiegirl Enthusiast

I'm a member of apfed.org, I have EE and EGID... So I like to say ED which means eosinophilic disorders (but seems to mean another disease that you take Viagra for!)

Anyhow, I also have Celiac and I got better when I went gluten-free but not entirely. I feel so lucky that I had a GI doctor that kept looking and I was diagnosed via a biopsy. Once I had the diagnosis I was sent to an allergist, allergy testing was done, elimination diet and I've pretty much got it under control. I take gastrocrom for it, which is a mast cell inhibitor and that has really helped me a lot.

I'd say that getting a proper diagnosis for EE is really important, otherwise you might be limiting foods or doing the wrong thing for a condition your child may or may not have.

Good luck,

Susan

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    • trents
      So the tTG-IGA at 28 is positive for celiac disease. There are some other medical conditions that can cause elevated tTG-IGA but this is unlikely. There are some people for whom the dairy protein casein can cause this but by far the most likely cause is celiac disease. Especially when your small bowel lining is "scalloped". Your Serum IGA 01 (aka, "total IGA") at 245 mg/dl is within normal range, indicating you are not IGA deficient. But I also think it would be wise to take your doctor's advice about the sucraid diet and avoiding dairy . . . at least until you experience healing and your gut has had a chance to heal, which can take around two years. After that, you can experiment with adding dairy back in and monitor symptoms. By the way, if you want the protein afforded by dairy but need to avoid casein, you can do so with whey protein powder. Whey is the other major protein in dairy.
    • jenniber
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    • JoJo0611
      Thank you this really helped. 
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    • GlorietaKaro
      One doctor suggested it, but then seemed irritated when I asked follow-up questions. Oh well—
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