I was eating roasted chicken at a chain restaurant the first time it happened. The meat got stuck somewhere in my esophagus and wouldn’t go down. Water didn’t help; in fact, it worsened the pain. I wasn’t choking and I could breathe, but my throat and chest felt like it was exploding. Tears dripped from my eyes, my face flushed, and I gripped onto the table. My children, then still in high school, looked as scared as I felt. Luckily, after a few very long minutes, the meat finally dislodged.
I blamed the whole incident on reflux since I’d been diagnosed with gastroesophageal reflux disease (GERD) years ago. Or, I thought, it could have something to do with my hiatal hernia, the other diagnosis I got long ago when I reported pain in my chest. When other strange symptoms popped up and tests came back confirming celiac disease and myriad food allergies, I suspected something else might be causing my throat to constrict.
The fourth doctor I saw performed an upper endoscopy and diagnosed eosinophilic esophagitis (EE or EoE). In simple terms, I have an allergic esophagus. Ah ha! I am extremely sensitive to even a tiny bit of soy and the chicken in the chain restaurant was cooked with soy oil. Thinking back, I can now pinpoint what foods I consumed–that I now know I’m allergic to–that caused food to get stuck.
So what exactly is EE? Basically, it’s when the esophagus, the tube connecting the mouth to the stomach, has severely elevated levels of eosinophils, a type of white blood cell. Eosinophils can attack the gastrointestinal system and cause vomiting and difficulty swallowing food. Reviewing my many lab reports over the years, I always had high eosinophils. Hmmm.
Symptoms of EE vary from person to person. Episodes like mine—inability to swallow food or vomit food up– are common. In severe cases, food stays stuck and medical help is needed. Some people may experience heartburn-like symptoms, but the symptoms frequently do not improve with acid blocking medications.
Diagnosis is made through an upper endoscopy. A doctor looks at the esophagus, stomach, and the first part of the small bowel and takes tissue samples (biopsies) to examine under a microscope. An abnormal number of eosinophils indicates EE. Other features of EE include whitish spots, long furrows, corrugated rings, or a lining that looks like crepe paper and is easily torn.
When first diagnosed, I used a steroid inhaler (sprayed into my mouth and swallowed) to reduce the inflammation and reduce the eosinophils. According to research, relapse after treatment occurs in at least 25 percent of patients. Fortunately, by eliminating the foods I react to, my EE has been kept under control.
If you suspect you have an allergic esophagus, make an appointment with a gastroenterologist who has experience in diagnosing EE (it’s a fairly new diagnosis but becoming more and more prevalent).
Here are some other useful resources:
New Allergy Causes Trouble Swallowing – WDBJ7 | @scoopit http://sco.lt/5AXW0P
- More patients diagnosed with EoE (news4jax.com)
- Allergies and Intolerances – is your comfort food your poison? (healthstudynotes.wordpress.com)