Eosinophilic Esophagitis in Children

Eosinophilic esophagitis (EoE) causes your child’s esophagus to inflame and fill up with white blood cells called eosinophils.

Remarkable care for kids

• Multidisciplinary care: The Pediatric Celiac Disease and Food Sensitivity Clinic is dedicated to diagnosing and caring for children with GI problems like eosinophilic esophagitis.  The clinic brings together pediatric allergists, pediatric gastroenterologists, dietitians and other pediatric specialists to create an individual treatment plan for your child. The clinic provides coordinated, compassionate care to children from birth to age 21.
• Family-centered care: As part of Rush University Children’s Hospital, clinicians at the clinic are dedicated to family-centered care. They believe your family should play an integral role in determining the best care plan to address your child’s unique needs and lifestyle.
• Care close to home: Pediatric gastroenterologists at Rush University Children’s Hospital are available to see patients at Rush University Medical Center in Chicago, Rush Oak Park Hospital in Oak Park and Rush Copley Medical Center in Aurora.

What is eosinophilic esophagitis (EoE)?

EoE can make it difficult to eat and can cause your child to vomit or have stomach pain. In older children, it may cause food to become stuck in the esophagus, which requires emergency treatment.

Diagnosing EoE can be hard, especially in children. That’s because eosinophilic esophagitis often looks like other conditions such as gastroesophageal reflux disease (GERD) and acid reflux or heartburn.

Eosinophilic esophagitis symptoms

These are the symptoms of eosinophilic esophagitis:

• Nausea
• Problems swallowing or trouble eating
• Vomiting
• Stomach pain
• Weight loss

Care eosinophilic esophagitis in children

Diagnosis

If you think your child has GERD or EoE, it’s very important to have your child’s doctors diagnose it as soon as possible. This will help make sure your child gets the nutrition they need to grow.

You and your child should first meet with your child’s primary care doctor to discuss symptoms.

If your child’s pediatrician or family medicine doctor suspects EoE or GERD, they will likely refer your child to a pediatric gastroenterologist. Pediatric gastroenterologists at Rush University Children’s Hospital will ask you and your child questions to get a full health picture and run diagnostic tests to determine the root of the problem.

They may then take the following steps:

• Rule out GERD. Depending on your child’s age, this may include prescribing medicine to reduce acid production in the stomach.
• Perform endoscopy and take cell samples to see if eosinophils are in the esophagus.

Your child’s care team

If your child’s care team finds that your child has eosinophilic esophagitis, they will take a closer look at the foods your child eats as foods can trigger EoE symptoms. Your child’s clinicians may ask you to track what your child eats in a food diary.

At Rush University Children’s Hospital, your child’s health care team will include the following:

• Pediatricians
• Pediatric gastroenterologists
• Pediatric allergy specialists
• Dietitians

They will partner with you, your child and your family to do the following:

• Help your child achieve a healthy weight
• Pinpoint the source of your child’s symptoms
• Develop a treatment plan

Finding the source of eosinophilic esophagitis

Causes of EoE

• Both genes and food allergies have been linked to EoE.
• Environmental allergies, such as pollen or dust allergies may also play a role in EoE.

Your health care team will look for the source of your child’s problem. They can do this in several ways:

• Perform skin prick and blood tests to find out what allergies your child may have.
• Eliminate foods known to cause allergic reactions, such as milk or wheat. Then, slowly re-introduce them to see what foods cause EoE symptoms.
• Remove all sources of protein and give your child a special formula for nutrition. Then, reintroduce foods to see what causes a response.

Treatment for eosinophilic esophagitis

Although there is currently no cure for EoE, doctors can help control your child’s symptoms. Once your child’s clinicians discover what’s causing the EoE symptoms, they work with you and your child to do the following:

• Remove the root cause from your child’s diet or environment.
• Prescribe medications, if needed. These could include corticosteroids to lessen inflammation in the esophagus. Or your child’s clinician may suggest proton pump inhibitors to reduce acid in the stomach.