GERD vs. EoE: Differences in Treatment | myEoEcenter (2023)

FAQs

What is the difference between GERD and eosinophilic esophagitis? ›

Generally, GERD presents with heartburn and regurgitation, whereas EoE presents with episodes of dysphagia and food impaction. However, GERD can also cause dysphagia, and EoE can also cause heartburn.

Your provider will likely first prescribe an acid blocker such as a PPI . This treatment is the easiest to use, but most people's symptoms don't improve. Topical steroid. If you do not respond to the PPI , your provider will then likely prescribe a steroid, such as fluticasone or budesonide.

Symptoms of heartburn, chest pain and dysphagia are recognized manifestations of both disorders, as is the presence of oesophageal eosinophilia. The prevalence of GERD in the general population (~20%) is sufficiently high enough to make coexistence of GERD with EoE inevitable.

However, there are some differences between GERD and esophagitis. GERD is characterized by acid reflux. Esophagitis is characterized by inflammation, which is commonly caused by acid reflux and GERD. But there are many other possible causes of esophagitis.

Unfortunately, because symptoms develop gradually, EoE is often misdiagnosed, or not caught at all until after tissue damage to the esophagus has already taken place.

It wasn't until the 1990s that doctors realized that EoE isn't caused by GERD. It's a similar but totally separate condition. Eosinophilic esophagitis is a chronic immune system disease that has identical symptoms to the digestive disease GERD (gastroesophageal reflux disease), like trouble swallowing and chest pain.

There is no cure for EoE. Treatments can manage your symptoms and prevent further damage. The two main types of treatments are medicines and diet.

A Breakthrough

DUPIXENT helps reduce EoE symptoms. DUPIXENT is a weekly injectable treatment given under the skin (subcutaneous injection).

Complications. The long-term complications of EoE are not clearly understood. If left untreated, symptoms will continue and damage to the esophagus causing narrowing may happen.

The foods that most commonly cause an allergic reaction leading to EoE include milk, eggs, wheat, soy, peanuts or tree nuts and fish or shellfish. You may have a combination of allergies that increase the risk of EoE.

Can you outgrow eosinophilic esophagitis? ›

Current data suggests that patients do not outgrow this condition. Rather, EoE is thought of as a “relapsing and remitting” disease in which the inflammation typically returns if therapy is discontinued.

Increased stress can worsen symptoms.

Acid reflux, hiatal hernias, vomiting, complications from radiation therapy, and certain oral medications are among the reasons the esophagus can develop inflamed tissue. Esophagitis can usually heal without intervention, but to aid in the recovery, eaters can adopt what's known as an esophageal, or soft food, diet.

According to the National Institute of Diabetes and Digestive and Kidney Diseases , only a small percentage of people with GERD develop Barrett's esophagus.

If the biopsies show at least 15 eos/hpf, then the diagnosis of EoE is a possibility, but it is not confirmed. The other causes of esophageal eosinophilia, in particular GERD and PPI-REE must be assessed, which is best done by treating with a high dose PPI trial for 8 weeks.

Eosinophilic esophagitis (EE) is characterized by eosinophilic infiltration of the esophageal mucosa and results in clinical signs and symptoms that may be indistinguishable from those of gastroesophageal reflux disease (GERD).

People with EoE may also be treated with oral or liquid steroids to decrease inflammation or with an immunomodulating medication. Many patients respond to these approaches within 6 to 8 weeks, their symptoms resolve, and they have no problem eating solid foods.

Heartburn-like pain is a common symptom of gastroesophageal reflux disease (GERD), but several other conditions can cause a burning feeling in your chest, including gallstones, stomach ulcer and esophageal cancer.

Allergists may do a series of different allergy tests to identify the foods causing EoE. Foods such as dairy products, egg, soy and wheat are main causes of EoE. However allergies to these foods often cannot be easily proven by conventional allergy tests (skin tests, patch tests or blood tests).

How do I get my EoE into remission? ›

Corticosteroids are another effective therapy for the treatment of EoE[70,71]. the formulation of the most commonly used corticosteroids, including budesonide, fluticasone propionate, and ciclesonide, influences histological remission.

In group 5 the caffeine increased the number of neutrophils 2.7-times and increased the number of eosinophils 4.6-times (P < 0.05) compared with control. Our study revealed that caffeine played an important role in the development of protective immune response.

Eat a healthy diet free of acidic foods: Both acid reflux and heartburn can raise your body's eosinophil count. To avoid these conditions, one must eat a balanced, healthy diet. Look for low-fat foods, including lean meats, whole grains, fresh fruits and vegetables, and whole-grain foods.

Commonly, the pain is presumed to be heartburn, burning in the chest or abdomen, but it does not improve after taking antacids (Tums, Rolaids, Zantac, Pepcid, etc.). In younger children, EoE is suspected when feeding problems or poor growth are discovered.

o Carry injectable epinephrine (Epi-Pen or Autoinjector) and an oral antihistamine such as Benadryl as prescribed for emergencies. If EoE is aggrevated by gastroesophageal reflux, treating the reflux may help the EoE. This may include medication, lifestyle, physical and dietary measures to decrease reflux.

Does Benadryl Relieve Eosinophilic Esophagitis? Benadryl, a diphenhydramine formulation, is an antihistamine acting against allergies. It was not found effective against eosinophilic esophagitis.

EoE is considered to be a chronic condition that can be medically managed, but is not outgrown. Eosinophils can be found in the esophageal tissue in diseases other than EoE.

The disease anxiety and choking anxiety subscales are also important contributors to HRQOL in adult EoE patients. In fact, a separate study found that disease anxiety and choking anxiety had the largest impacts on overall HRQOL in the EoE population.

EoE Makes It Harder to Eat

Because it's hard to swallow, some children with EoE eat very little or they won't eat at all. This can make it hard for them to get the proper nutrition that they need to grow and develop. When EoE is severe, the esophagus can narrow so much that food gets stuck inside it.

What Causes EoE? According to Dr. Gramling, the rise in EoE cases found in children is likely due to increasing allergies of all types and improved awareness about the disorder.

What causes EoE flare ups? ›

The most common allergens that cause EoE to flare are milk, eggs, soy and dairy. But it can be hard to track due to the nature of how the flare ups occur. “With something like a peanut allergy the response is immediate,” said Robson. “But with EoE it is more of a delayed reaction.

EoE is not life threatening; however, if left untreated it may cause permanent damage to the esophagus. Many patients with EoE also experience gastroesophageal reflux disease (GERD), a chronic digestive disorder that is caused by the abnormal flow of gastric acid from the stomach into the esophagus.

The frequency of eosinophilic esophagitis has been estimated to be approximately 1 in 2,000 individuals.

Eosinophilic esophagitis (EoE) is a chronic, allergic disease associated with marked mucosal eosinophil accumulation. Multiple studies have reported a strong familial component to EoE, with the presence of EoE increasing risk for other family members with EoE.

Vomiting. Abdominal pain. Difficulty swallowing, also called dysphagia. Food getting stuck in the esophagus after swallowing, also known as impaction.

Although EoE typically presents in school-age children (6-12 years) and young adults (third-fourth decade of life),16 it can also present in infancy (<_12 months).

Difficulty swallowing. Painful swallowing. Swallowed food becoming stuck in the esophagus, also known as food impaction. Chest pain, particularly behind the breastbone, that occurs with eating.

Although healing of the esophagus may occur in 6 to 8 weeks, it should not be misunderstood that gastroesophageal reflux can be cured in that amount of time. The goal of therapy for GERD is to keep symptoms comfortably under control and prevent complications.

The cumulative healing rates in the initial healing period on omeprazole 20 mg daily were: 77% at four weeks; 87% at eight weeks; and 95% at 12 weeks (table 3). Fourteen of 15 patients unhealed after 12 weeks received omeprazole 40 mg daily for a further 12 weeks; 13 healed at the end of this period (table 3).

It can vary. For some folks, it can last just a few minutes. Sometimes it can last for several hours. Heartburn happens about once a week for up to 20% of Americans and is common in pregnant women.

What are red flags for GERD? ›

Alarm symptoms include dysphagia (difficulty swallowing) and odynophagia (painful swallowing), which may represent presence of complications such as strictures, ulceration, and/or malignancy. Other alarm signs and symptoms include, but are not limited to, anemia, bleeding, and weight loss.

Yes, GERD can be cured. The most common treatment for Gastroesophageal Reflux Disease is medication, which can help to decrease the amount of acid in your stomach. If lifestyle changes don't help, your doctor may also recommend surgery.

It might take 1 to 3 weeks to heal. Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems.

This method connected the jejunum to the esophagogastric anastomosis in rats to induce reflux of gastric acid and duodenal fluid into the esophagus, creating a condition similar to that of human esophageal reflux. Barrett's esophagus developed after 20 wk, while esophageal adenocarcinoma appeared after 40 wk[72].

Use high protein, thick liquids and higher calorie items, such as milkshakes, custard, pudding, macaroni and cheese, etc. Some other soft or liquid-‐type foods are applesauce, cooked cereals, strained cream soup, mashed potatoes, Jello, rice pudding, etc.

Causes. EoE is caused by an allergic reaction to certain foods or environmental allergens.

The six-food elimination diet (SFED) is the most frequently employed dietary therapy in patients with EoE. This diet typically trials the exclusion of wheat, milk, egg, nuts, soy, fish and shellfish.

A: Yes, although GERD is a common cause of esophagitis, it is possible to develop GERD without also developing esophagitis. There is debate over whether this should be considered a sub-entity of GERD or a condition of its own called non-erosive reflux disease (NERD).

Prevalence and Consequences: EoE prevalence has increased over the past 2 decades, nearly doubling in both adults and children, and occurring in an estimated one in 1,500 to 2,000 persons. EoE affects more adults than children (19.1 cases/100,000 vs.

Empiric elimination diet: An empiric elimination diet eliminates all major food allergens from the diet. These foods usually include dairy, egg, wheat, soy, peanuts, tree nuts, fish, and shellfish. These types of diets have been proven effective at treating eosinophilic esophagitis.

Can probiotics help eosinophilic esophagitis? ›

Conclusion. Probiotics can be used as adjuvant treatment for patients with EoE. Improvement in the severity of chest pain and poor appetite and reduction in the frequency of nausea and poor appetite in these patients can be seen.

When the researchers examined a cohort of patients with EoE, they found that many of these patients had a vitamin D deficiency, Rothenberg said. Biopsies revealed that the severity of their disease, including eosinophil levels, histological changes and other features, were inversely proportional to vitamin D levels.

Acid reflux, hiatal hernias, vomiting, complications from radiation therapy, and certain oral medications are among the reasons the esophagus can develop inflamed tissue. Esophagitis can usually heal without intervention, but to aid in the recovery, eaters can adopt what's known as an esophageal, or soft food, diet.