What is Eosinophilic Esophagitis?
Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus, immune-mediated, mainly due to various protein antigens from food and the environment. It is characterized by esophageal dysfunction due to white blood cells called eosinophils that act to defend the body. These eosinophils are deposited on the esophageal walls causing inflammation of the tube.
Eosinophilic esophagitis currently affects about 40,000 people in Spain. Currently it continues to be a rare disease, with an increasing prevalence in our country.
What symptoms does Eosinophilic Esophagitis have?
The symptoms are very varied and depend on whether we are talking about pediatrics or adults, we could group the most characteristic.
Comment that EoE is the main cause of dysphagia in the world in young adult patients and it could be said that it is the main symptom of the disease.
Other of the most characteristic symptoms could be chest pain, vomiting, weight loss, food rejection and one of the most important food impactions that require emergency intervention to remove the foreign body.
Treatment and diagnosis of EoE?
Let’s not forget that there may be suspicion of EoE by listening to patients and their symptoms, but the only diagnosis for Eosinophilic Esophagitis is through endoscopy with biopsies. It is an abrasive technique, but it is the only way to successfully diagnose it. In the analysis of the samples there must be more than 15 eosinophils per high power field.
The treatments available in our country are varied, we can talk about the following:
– Food elimination diets, foods that cause inflammation of the esophagus.
– PPI: proton pump inhibitors, drugs known as Omeprazole.
– Corticosteroids.
What consequences does this pathology have for the Quality of Life and Psychology of patients?
For patients who suffer from this type of disease, we see how our quality of life deteriorates. Social life decreases since due to impacts we are afraid to go out to eat, and in our country gastronomic tourism seems to be the main leisure activity. We meet for a snack, breakfast, dinner, lunch…
When you suffer from this disease, those outings are forgotten, you prefer to stay at home so as not to suffer eating or have a moment of tension.
Traveling becomes impossible, how to explain in another language that you cannot eat X foods? If you choke, how can you explain your disease in a health center in another country?
Even going to the mountain in a rural house or to any place of relaxation can be an odyssey.
Let’s not forget that for this disease to subside you need to be on treatment, either pharmacological or dietary. This also affects, not eating food can be exasperating and the fact of having to maintain a consistency in the elimination of food sometimes becomes an impossible goal. It is true that you can get better, but seeing your family or friends eat products that you cannot or should not, in the end you end up sinning and you fall into temptation.
Psychologically, all of the above affects. As we have well commented, being with lifelong treatments affects negatively, it can cause stress, anxiety, even depression. Relying on a daily medication for a lifetime causes despair that is hard to explain. Many of the patients suffer from an anxious-depressive disorder at some point in their lives because of the disease. Not going out, not traveling, not having a social life, not having an optimal quality of life, causes us to suffer those episodes of anxiety, episodes of stress or, most importantly, a depression that is sometimes prolonged over time.
Let’s not forget that the fact of choking causes us to become afraid of food, which psychologists call “phagophobia”. Sitting down to eat after having choked is a struggle, a struggle that needs psychological help, because you see food as enemies.
Eating porridge because of dysphagia also makes you look at food with another face, you are no longer attracted to those foods that used to do so because you have to eat them crushed and you are overwhelmed by monotony.
In many cases this affects weight, in my personal case I lost about 20 kilos in less than 7 months.
How does the disease affect work?
If you don’t eat properly, if you don’t rest, if you live in constant concern about illness, all this has a negative impact on work. On many occasions, the lack of food causes both physical and mental fatigue, in physical work all this conditions in a higher way, but also in work that you are sitting in front of a computer or for example paperwork. You don’t think the same because you don’t have those nutrients necessary to lead a full life.
How sick of EoE, what advice would you give or what would you ask for?
We fight to live daily against this disease, many times our disease is confused with psychological problems, due to dysphagia that feeling of a knot in the esophagus, it is also experienced on many occasions in anxiety attacks. Listening to patients should be essential, since many people have been slow to be diagnosed because they ignore or confuse anxiety with the disease.
The multidisciplinary work between specialists should be essential, allergists, digestive specialists, nutritionists, pharmacologists, nurses, nutritionists and primary care physicians. This disease should be present, since they influence all fields.
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This information should never replace the opinion of a doctor. If in doubt, consult professionals.