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Eosinophilic esophagitis (EoE)EEosinophilic esophagitis (EoE)Eosinophilic esophagitis (EoE)EnglishGastrointestinalChild (0-12 years);Teen (13-18 years)EsophagusEsophagusConditions and diseasesCaregivers Adult (19+)NA2012-01-03T05:00:00ZMargaret A. Marcon, MD, FRCPC;Vikki Scaini, BA, RN;Andrea Lall, RN8.0000000000000062.00000000000001057.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Information for parents about eosinophilic esophagitis, a disease that causes trouble swallowing and pain.</p><h2>What is eosinophilic esophagitis (EoE)?</h2> <figure><span class="asset-image-title">Esophagus</span><img src="https://assets.aboutkidshealth.ca/akhassets/Esophagus_MED_ILL_EN.jpg" alt="Upper body of a boy with esophagus and stomach identified" /> </figure> <p>The esophagus (say: ee-SOFF-a-gus) is the tube that carries food from the mouth to the stomach. Eosinophilic esophagitis (say: EE-oh-sin-oh-FILL-ick ee-SOFF-a-JIE-tiss) is a disease that causes inflammation in the esophagus.</p><p>EoE can affect people of any age, gender and ethnic background. It seems to affect males more often than females. It may run in some families. EoE occurs in one in 10,000 people.</p><h2>Key points</h2> <ul> <li>Eosinophilic esophagitis is a disease that causes narrowing of the esophagus, the tube that carries food from the mouth to the stomach.</li> <li>Symptoms of EoE may include pain, poor appetite, poor weight gain, trouble swallowing or food getting stuck in the esophagus.</li> <li>Your child may need a medication trial, a blood test and an endoscopy with biopsies to diagnose EoE.</li> <li>EoE is treated with medication and/or diet changes.</li> </ul><h2>Symptoms of EoE</h2> <p>Symptoms of EoE are different in different people and at different ages. </p> <p>In children, the most common symptoms of EoE are:</p> <ul> <li>food and acid going back into the esophagus from the stomach (reflux) that does not respond to usual treatments </li> <li>chest pain or abdominal (stomach) pain</li> <li>poor appetite</li> <li>poor weight gain</li> <li>failure to thrive</li> <li>trouble sleeping</li> <li>trouble swallowing (dysphagia)</li> <li>food getting stuck in the esophagus</li> <li>nausea and vomiting</li> </ul><h2>What causes eosinophilic esophagitis?</h2><p>EoE happens when a large number of white blood cells called eosinophils travel to the esophagus.</p><p>An eosinophil (say: ee-oh-SIN-o-fill) is a type of white blood cell that is made in the bone marrow. Eosinophils are an important part of the immune system because they help to fight off certain types of infections. But when there are too many of them in one part of the body, they can cause inflammation. These cells also play a role in the mechanisms that cause allergies and asthma.</p><p>We are not sure what triggers EoE. Allergies to food or environmental factors may trigger it. People with EoE often have other allergic diseases such as <a href="/Article?contentid=1470&language=English">asthma</a>, <a href="/Article?contentid=773&language=English">eczema</a>, seasonal runny nose and sinus problems. </p><h2>Diagnosis of EoE</h2><p>At your child's first appointment with the gastroenterology doctor, they may be started on a medicine for acid reflux. Your child will need to take this medication for six to eight weeks. </p><p>If the symptoms do not get better with this medication, then your doctor may think your child has EoE and will want to have additional testing done. The doctor will order blood work, including a complete blood count (CBC) and differential. The blood count may show a high eosinophil count or a high level of antibodies called IgE. These results may suggest EoE, but they are not enough to diagnose EoE by themselves. These tests can also be normal, even if you have EoE. </p><p>The next step to diagnose EoE is an <a href="/Article?contentid=2472&language=English">upper endoscopy</a> with biopsies: </p><ul><li>Often an endoscopy is peformed. An endoscopy is when a flexible tube with a light and a tiny camera at the end (an endoscope) is inserted through the mouth and examines the esophagus, stomach, and first part of the small intestine.</li><li>A biopsy is when a tiny piece of tissue is cut out so it can be examined under a microscope. </li></ul><p>This will help make a diagnosis. Having many eosinophils in the esophagus would support the diagnosis of EoE.</p> <figure class="asset-c-80"> <span class="asset-image-title"></span><span class="asset-image-title">Eosinophil</span><img src="https://assets.aboutkidshealth.ca/akhassets/Eosinophil_MED_ILL_EN.jpg" alt="A cell with nucleus and granules identified" /><figcaption class="asset-image-caption">An</figcaption><figcaption class="asset-image-caption"> eosinophil is a type of white blood cell. It has a nucleus with two lobes, and is filled with small granules.</figcaption> </figure><h2>Treatment for EoE</h2> <p>There are a few different ways to treat EoE, depending on your child's age and overall health. After the diagnosis is made, you and your family will meet with your health care team and decide which treatment is the most appropriate. It is a joint decision between the health care team and the family. The most common treatment options are discussed here.</p> <h3>Medication</h3> <p>Your child may be prescribed a mild steroid medication. The purpose of this medication is to reduce the number of eosinophils in the esophagus and help your child swallow more easily. Two different medications are used: </p> <ul> <li><a href="/Article?contentid=87&language=English">budesonide</a></li> <li><a href="/Article?contentid=143&language=English">fluticasone</a></li> </ul> <p>Which one is chosen will depend on your child's age. </p> <p>If your child takes the medication as directed, your child's symptoms should improve within days or weeks. </p> <h3>Diet (food) changes</h3> <p>Some children with EoE find that symptoms may get worse with certain foods. If their diet is changed slightly, their symptoms may improve. This is called diet therapy. Diet changes are guided by your health care team. Your child may be referred to an allergist, who will help determine if certain foods trigger the symptoms of EoE. </p> <p>Sometimes, even with medication and simple dietary changes, your child will still have symptoms that are hard to manage. If this happens, the health care team may suggest taking certain foods out of your child's diet completely. This is called an elimination diet.</p> <p>There are a few different ways to try elimination diets:</p> <ol> <li>Cut out foods identified by an allergist.</li> <li>Cut out additional foods, including some or all from the major food groups that are known to worsen symptoms in many people with EoE. These include milk, soy, peanuts, tree nuts, eggs, wheat and seafood. </li> <li>The last type of elimination diet is the strictest, but it can help find out which foods make symptoms worse. Your child will be prescribed a strict diet of a special liquid nutritional product for four to six weeks. During this time, your child will not be allowed to eat any other food. After this time has passed, different foods will be slowly introduced while you and the health care team watch your child for symptoms. </li> </ol> <p>None of these diet options are easy. The health care team will assess your child and discuss the best options with your family. </p>
L’œsophagite éosinophiliqueLL’œsophagite éosinophiliqueEosinophilic esophagitis (EoE)FrenchGastrointestinalChild (0-12 years);Teen (13-18 years)EsophagusEsophagusConditions and diseasesAdult (19+) CaregiversNA2012-01-03T05:00:00ZMargaret A. Marcon, MD, FRCPC;Vikki Scaini, BA, RN;Andrea Lall, RNHealth (A-Z) - ConditionsHealth A-Z<p>Information destinée aux parents et portant sur l’œsophagite éosinophilique, trouble douloureux qui rend la déglutition difficile.</p><h2>Qu’est-ce que l’œsophagite éosinophilique?</h2> <figure> <span class="asset-image-title">L’œsophage</span><img src="https://assets.aboutkidshealth.ca/akhassets/Esophagus_MED_ILL_FR.jpg" alt="La partie supérieure du corps d’un garçon avec l’œsophage et l’estomac identifiés" /> </figure> <p>L’œsophage est le tube qui fait passer la nourriture de la bouche à l’estomac. L’œsophagite éosinophilique est l’inflammation de l’œsophage.</p><p>L’œsophagite éosinophilique touche des patients de tout âge, des deux sexes et de toute origine ethnique. Il semble toutefois que les hommes en souffrent plus souvent que les femmes. Elle est congénitale dans certaines familles. Elle touche une personne sur 10 000.<br></p><h2>À retenir</h2><ul><li>L’œsophagite à éosinophiles est une maladie qui provoque le rétrécissement de l’œsophage, le tube situé entre la bouche et l’estomac qui sert à l’alimentation.</li><li>Les symptômes de l’œsophagite à éosinophiles comprennent, entre autres, des douleurs, un faible gain pondéral et de la difficulté à avaler ou à faire descendre les aliments dans l’œsophage.</li><li>Le diagnostic de la maladie peut exiger l’essai de plusieurs médicaments, une analyse sanguine et une endoscopie accompagnée de biopsies pour poser le diagnostic de l’œsophagite à éosinophiles.</li><li>La maladie peut être traitée avec des médicaments et des modifications apportées au régime alimentaire.</li></ul><h2>Symptômes de l’œsophagite éosinophilique</h2><p>Les symptômes diffèrent d’une personne à l’autre et varient selon l’âge.</p><p>Chez les enfants, les symptômes les plus fréquemment observés sont les suivants :</p><ul><li>reflux gastro-œsophagien (nourriture et acide de l’estomac remontant dans l’œsophage) qui ne répond pas aux traitements usuels</li><li>douleurs dans la poitrine et à l’abdomen (ventre)</li><li>manque d’appétit</li><li>enfant qui tarde à prendre du poids</li><li>retard de croissance</li><li>insomnie</li><li>dysphagie (difficulté à avaler)</li><li>aliments pris dans l’œsophage</li><li>nausée et vomissements</li></ul><h2>Quelles sont les causes de l’œsophagite éosinophilique?</h2><p>L’œsophagite éosinophilique se déclare lorsqu’un grand nombre de globules blancs, appelés éosinophiles, s’accumulent dans l’œsophage.</p><p>Un éosinophile est un type de globule blanc fabriqué par la moelle osseuse. Ils constituent un élément important du système immunitaire, car ils contribuent à combattre certains types d’infections. Ils peuvent cependant provoquer une inflammation lorsqu’ils sont trop nombreux dans une partie du corps. Ils jouent aussi un rôle dans le mécanisme des allergies et de l’asthme.</p><p>Nous ne savons pas trop ce qui déclenche l’œsophagite éosinophilique, peut-être des allergies alimentaires ou des facteurs environnementaux. Les personnes atteintes de cette inflammation souffrent souvent d’autres maladies allergiques : <a href="/Article?contentid=1470&language=French">asthme</a>, <a href="/Article?contentid=773&language=French">eczéma</a>, écoulements nasaux saisonniers et problèmes de sinus.<br></p><h2>Diagnostic de l’œsophagite éosinophilique</h2><p>Au premier rendez-vous de votre enfant chez son gastroentérologue, il se peut que le spécialiste lui prescrive un médicament contre le reflux gastro-œsophagien qu’il devra prendre de six à huit semaines.</p><p>Si ce médicament ne soulage pas ses symptômes, le gastroentérologue pourrait diagnostiquer une œsophagite éosinophilique et recommandera alors d’autres tests. Il prescrira une analyse sanguine, dont un hémogramme et une numération différentielle. Il est possible que l’hémogramme indique une abondance d’éosinophiles ou d’anticorps appelés immunoglobulines E. Bien que ces résultats laissent croire que le patient souffre peut-être d’œsophagite éosinophilique, ils ne sont pas suffisants pour la diagnostiquer. Par ailleurs, il peut être atteint de cette infection sans que les tests indiquent quoi que ce soit d’anormal.<br></p> <figure class="asset-c-80"><span class="asset-image-title">Éosinophile</span><img src="https://assets.aboutkidshealth.ca/akhassets/Eosinophil_MED_ILL_FR.jpg" alt="Un globule avec le noyau et les granulations identifiés" /><figcaption class="asset-image-caption">Un éosinophile est un type de globule blanc. Il a un noyau à deux lobes et est rempli de petits granulations.</figcaption> </figure> <p>La prochaine étape du diagnostic est une <a href="/Article?contentid=2472&language=French">endoscopie digestive haute</a> accompagnée de biopsies :</p><ul><li>On procède souvent à une endoscopie. L’endoscopie est une intervention où l’on insère par la bouche du patient un endoscope, qui consiste en un tube souple équipé à son extrémité d’une lampe et d’une minuscule caméra et qui sert à examiner l’œsophage, l’estomac et la première partie de l’intestin grêle.</li><li>La biopsie est l’action de prélever un petit morceau de tissu, puis de l’examiner au microscope.</li><li>Ces interventions aideront à poser le diagnostic. Si le patient a un grand nombre d’éosinophiles dans son œsophage, il est probablement atteint d’œsophagite éosinophilique.</li></ul><h2>Traitement de l’œsophagite éosinophilique</h2><p>Il existe plusieurs façons de traiter l’œsophagite éosinophilique, selon l’âge et l’état de santé général de votre enfant. Après le diagnostic, vous et votre famille vous réunirez avec l’équipe de soins de santé et opterez pour le meilleur traitement. C’est une décision que la famille et l’équipe de soins de santé doivent prendre en commun. Nous discuterons ici des options de traitement les plus fréquentes.</p><h3>Médicaments</h3><p>Il se peut qu’on prescrive à votre enfant l’un des deux stéroïdes légers suivants, en vue de réduire le nombre d’éosinophiles dans son œsophage et de l’aider à mieux avaler :</p><ul><li><a href="/Article?contentid=87&language=French">budésonide</a></li><li><a href="/Article?contentid=143&language=French">fluticasone</a></li></ul><p>Le choix de l’un plutôt que l’autre dépend de l’âge de votre enfant.</p><p>S’il suit les recommandations de son médecin lorsqu’il prend ses médicaments, ses symptômes devraient s’améliorer au bout de quelques jours ou de quelques semaines.</p><h3>Changement de régime alimentaire</h3><p>Certains enfants atteints d’œsophagite éosinophilique découvrent que leurs symptômes empirent parfois lorsqu’ils consomment certains aliments. Ils pourraient peut-être les améliorer en modifiant un peu leur régime. C’est ce qu’on appelle un traitement diététique. C'est votre équipe de soins de santé qui vous guidera en ce sens. Il se peut qu’on recommande votre enfant à un allergologue, qui aidera à déterminer si certains aliments causent les symptômes de l’œsophagite éosinophilique. Il arrive que, même si votre enfant prend les médicaments prescrits et suit un régime simple, il continue de manifester des symptômes difficiles à gérer. Si c’est le cas, l’équipe de soins de santé peut vous suggérer d’éliminer complètement certains aliments du régime de votre enfant. C’est ce qu’on appelle un régime d’élimination.</p><p>Il existe trois types de régimes d’élimination :</p><ol><li>Éliminer les aliments interdits par l’allergologue.</li><li>Éliminer d’autres aliments, notamment une partie ou la totalité des groupes alimentaires importants dont on sait qu’ils empirent les symptômes chez plusieurs patients souffrant d’œsophagite éosinophilique : le lait, le soya, les arachides, les noix, les œufs, le blé et les fruits de mer.</li><li>Le dernier type est le plus strict. Il peut toutefois aider à découvrir quels aliments empirent les symptômes. De quatre à six semaines, on prescrira à votre enfant un régime spécial à base d’un liquide nutritif particulier. Pendant cette période, il ne pourra consommer aucun autre aliment. Au bout de ce délai, on introduira graduellement d’autres aliments, et vous et l’équipe de soins de santé vérifierez si ses symptômes réapparaissent.</li></ol><p>Aucun de ces régimes n’est facile. L’équipe de soins de santé évaluera votre enfant et discutera des options avec votre famille.</p>

 

 

Eosinophilic esophagitis (EoE)824.000000000000Eosinophilic esophagitis (EoE)Eosinophilic esophagitis (EoE)EEnglishGastrointestinalChild (0-12 years);Teen (13-18 years)EsophagusEsophagusConditions and diseasesCaregivers Adult (19+)NA2012-01-03T05:00:00ZMargaret A. Marcon, MD, FRCPC;Vikki Scaini, BA, RN;Andrea Lall, RN8.0000000000000062.00000000000001057.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Information for parents about eosinophilic esophagitis, a disease that causes trouble swallowing and pain.</p><h2>What is eosinophilic esophagitis (EoE)?</h2> <figure><span class="asset-image-title">Esophagus</span><img src="https://assets.aboutkidshealth.ca/akhassets/Esophagus_MED_ILL_EN.jpg" alt="Upper body of a boy with esophagus and stomach identified" /> </figure> <p>The esophagus (say: ee-SOFF-a-gus) is the tube that carries food from the mouth to the stomach. Eosinophilic esophagitis (say: EE-oh-sin-oh-FILL-ick ee-SOFF-a-JIE-tiss) is a disease that causes inflammation in the esophagus.</p><p>EoE can affect people of any age, gender and ethnic background. It seems to affect males more often than females. It may run in some families. EoE occurs in one in 10,000 people.</p><h2>Key points</h2> <ul> <li>Eosinophilic esophagitis is a disease that causes narrowing of the esophagus, the tube that carries food from the mouth to the stomach.</li> <li>Symptoms of EoE may include pain, poor appetite, poor weight gain, trouble swallowing or food getting stuck in the esophagus.</li> <li>Your child may need a medication trial, a blood test and an endoscopy with biopsies to diagnose EoE.</li> <li>EoE is treated with medication and/or diet changes.</li> </ul><h2>Symptoms of EoE</h2> <p>Symptoms of EoE are different in different people and at different ages. </p> <p>In children, the most common symptoms of EoE are:</p> <ul> <li>food and acid going back into the esophagus from the stomach (reflux) that does not respond to usual treatments </li> <li>chest pain or abdominal (stomach) pain</li> <li>poor appetite</li> <li>poor weight gain</li> <li>failure to thrive</li> <li>trouble sleeping</li> <li>trouble swallowing (dysphagia)</li> <li>food getting stuck in the esophagus</li> <li>nausea and vomiting</li> </ul><h2>What causes eosinophilic esophagitis?</h2><p>EoE happens when a large number of white blood cells called eosinophils travel to the esophagus.</p><p>An eosinophil (say: ee-oh-SIN-o-fill) is a type of white blood cell that is made in the bone marrow. Eosinophils are an important part of the immune system because they help to fight off certain types of infections. But when there are too many of them in one part of the body, they can cause inflammation. These cells also play a role in the mechanisms that cause allergies and asthma.</p><p>We are not sure what triggers EoE. Allergies to food or environmental factors may trigger it. People with EoE often have other allergic diseases such as <a href="/Article?contentid=1470&language=English">asthma</a>, <a href="/Article?contentid=773&language=English">eczema</a>, seasonal runny nose and sinus problems. </p><h2>Diagnosis of EoE</h2><p>At your child's first appointment with the gastroenterology doctor, they may be started on a medicine for acid reflux. Your child will need to take this medication for six to eight weeks. </p><p>If the symptoms do not get better with this medication, then your doctor may think your child has EoE and will want to have additional testing done. The doctor will order blood work, including a complete blood count (CBC) and differential. The blood count may show a high eosinophil count or a high level of antibodies called IgE. These results may suggest EoE, but they are not enough to diagnose EoE by themselves. These tests can also be normal, even if you have EoE. </p><p>The next step to diagnose EoE is an <a href="/Article?contentid=2472&language=English">upper endoscopy</a> with biopsies: </p><ul><li>Often an endoscopy is peformed. An endoscopy is when a flexible tube with a light and a tiny camera at the end (an endoscope) is inserted through the mouth and examines the esophagus, stomach, and first part of the small intestine.</li><li>A biopsy is when a tiny piece of tissue is cut out so it can be examined under a microscope. </li></ul><p>This will help make a diagnosis. Having many eosinophils in the esophagus would support the diagnosis of EoE.</p> <figure class="asset-c-80"> <span class="asset-image-title"></span><span class="asset-image-title">Eosinophil</span><img src="https://assets.aboutkidshealth.ca/akhassets/Eosinophil_MED_ILL_EN.jpg" alt="A cell with nucleus and granules identified" /><figcaption class="asset-image-caption">An</figcaption><figcaption class="asset-image-caption"> eosinophil is a type of white blood cell. It has a nucleus with two lobes, and is filled with small granules.</figcaption> </figure><h2>Treatment for EoE</h2> <p>There are a few different ways to treat EoE, depending on your child's age and overall health. After the diagnosis is made, you and your family will meet with your health care team and decide which treatment is the most appropriate. It is a joint decision between the health care team and the family. The most common treatment options are discussed here.</p> <h3>Medication</h3> <p>Your child may be prescribed a mild steroid medication. The purpose of this medication is to reduce the number of eosinophils in the esophagus and help your child swallow more easily. Two different medications are used: </p> <ul> <li><a href="/Article?contentid=87&language=English">budesonide</a></li> <li><a href="/Article?contentid=143&language=English">fluticasone</a></li> </ul> <p>Which one is chosen will depend on your child's age. </p> <p>If your child takes the medication as directed, your child's symptoms should improve within days or weeks. </p> <h3>Diet (food) changes</h3> <p>Some children with EoE find that symptoms may get worse with certain foods. If their diet is changed slightly, their symptoms may improve. This is called diet therapy. Diet changes are guided by your health care team. Your child may be referred to an allergist, who will help determine if certain foods trigger the symptoms of EoE. </p> <p>Sometimes, even with medication and simple dietary changes, your child will still have symptoms that are hard to manage. If this happens, the health care team may suggest taking certain foods out of your child's diet completely. This is called an elimination diet.</p> <p>There are a few different ways to try elimination diets:</p> <ol> <li>Cut out foods identified by an allergist.</li> <li>Cut out additional foods, including some or all from the major food groups that are known to worsen symptoms in many people with EoE. These include milk, soy, peanuts, tree nuts, eggs, wheat and seafood. </li> <li>The last type of elimination diet is the strictest, but it can help find out which foods make symptoms worse. Your child will be prescribed a strict diet of a special liquid nutritional product for four to six weeks. During this time, your child will not be allowed to eat any other food. After this time has passed, different foods will be slowly introduced while you and the health care team watch your child for symptoms. </li> </ol> <p>None of these diet options are easy. The health care team will assess your child and discuss the best options with your family. </p><h2>Living with eosinophilic esophagitis</h2> <p>Coping with taking medications and restricted diets can be difficult for anyone, especially a child. If your child seems to be having trouble dealing with the treatment of EoE, you can be a great source of comfort and help:</p> <ul> <li>Keep the lines of communication open. </li> <li>Be sure to let your child know that it is normal to feel sad or anxious. </li> <li>Assure your child that taking their medications every day and following their new diet will help them lead a healthy life. </li> <li>Let them know it is important to talk about their feelings with a parent or a doctor.</li> </ul>https://assets.aboutkidshealth.ca/akhassets/Esophagus_MED_ILL_EN.jpgEosinophilic esophagitis (EoE)False

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