If you have eosinophilic esophagitis (EoE), you may go to your primary doctor first. They may recommend that you see a specialist, like an allergist, a gastroenterologist, or both, to help you manage EoE.
Questions Your Doctor May Ask
At your first appointment, your doctor will ask you questions about your medical history and your family’s health history.
They’ll ask about your symptoms and how long you’ve had them. EoE may be related to other conditions, so they may ask about things like allergies, asthma, and acid reflux to rule out other causes of problems in your esophagus.
Your doctor may ask questions like:
- What are your symptoms?
- How long have you had them?
- Do you always have them or do they go away and come back?
- How severe are they?
- What makes them better?
- What makes them worse?
- Are they worse after meals?
- How do they feel when you lie down?
- Are they worse at night?
- Do they interfere with your sleep?
- Is it hard to swallow sometimes?
- Do you get food stuck when you swallow?
- Do you feel food come up the back of your throat?
- Do you have chest pain?
- Do you have stomach pain?
- Do you get nauseous?
- Do you vomit?
- Have you ever taken topical steroids?
- Have you ever eliminated foods from your diet?
- Have you gained or lost weight?
- Do your symptoms get worse during certain seasons?
- Do you have asthma or other chronic respiratory diseases?
- Do you have allergies to certain foods or environmental allergies to things like pollen?
- Do allergies run in your family?
- Did you try any medication, like an antacid or acid reflux medication?
- Did the medication help?
It may be helpful to prepare for these questions by gathering information you can share with your doctor. Try writing down details about your symptoms and a list of questions before your appointment.
Testing for Eosinophilic Esophagitis
Your doctor may do a physical exam to look for inflammation and other signs of EoE. They’ll also run tests to see if you have EoE.
Endoscopy. The most common test for EoE is an endoscopy. This is a procedure where your doctor looks at your esophagus with a thin, flexible tool, called an endoscope. It goes through your mouth and throat. The endoscope has a camera on the end of it so your doctor can see your esophagus.
Your gastroenterologist will perform the endoscopy. A gastroenterologist is a doctor that specializes in digestive disorders. They’re trained and experienced in understanding how your stomach and swallowing work.
During your endoscopy, your doctor will look for inflammation, swelling, horizontal rings, vertical furrows, narrowing, and white spots, which are signs of EoE. But not everyone with EoE has these signs.
Biopsy. During your endoscopy, your doctor may take a small sample of tissue from your esophagus. This is called a biopsy. Your doctor may take several tissue samples, then look at them through a microscope.
The tissue samples are very small, about the size of a tip of a pen.
Blood tests. If your doctor thinks you may have EoE, they may want to run blood tests to find out if your reactions are linked to allergies.
An allergist can do your blood tests. If your eosinophil and immunoglobulin E levels are high, you may have allergies. The blood test may show what’s causing your allergic reactions.
Esophageal sponge. Your doctor may do a test called an esophageal sponge to help you see how inflamed your esophagus is. You can do this test in your doctor’s office.
Your doctor will give you a capsule to swallow. The capsule is attached to a string. After it dissolves in your stomach, a sponge is released. Then your doctor can pull the string and the sponge will come out with a tissue sample from your esophagus.
Getting More Information About Eosinophilic Esophagitis
Your doctor will look at your test results, exam, and questions. Then they’ll tell you if you have a diagnosis of EoE.
If you have EoE, they’ll create a plan to manage it.
Your gastroenterologist will decide when you should have follow-up endoscopies or other tests.
Your allergist will help you manage your allergies and tell you which things you need to avoid.
Your doctor may recommend changing your diet and eliminating certain foods. They may try to reintroduce some foods later.
Your doctors will talk to each other to agree on what’s best for you and help you manage EoE together.
Your care team may also recommend getting support. Reaching out to organizations that specialize in EoE and joining a support group with other people who are living with EoE can help you feel less overwhelmed and learn how to manage life better.
Try these resources:
- American Partnership for Eosinophilic Disorders
- Campaign Urging Research for Eosinophilic Disease
Show Sources
Photo Credit: DigitalVision/Getty Images
SOURCES:
American College of Allergy, Asthma & Immunology: “Eosinophilic Esophagitis.”
Johns Hopkins Medicine: “Eosinophilic Esophagitis.”
Mayo Clinic: “Eosinophilic Esophagitis.”
Sutter Health: “Tips for Choosing a Gastroenterologist.”
