Center for Eosinophilic Disorders

The MUSC Children’s Center for Eosinophilic Disorders provides comprehensive medical care to children with eosinophilic disorders, such as eosinophilic esophagitis (EoE), eosinophilic gastritis (EG), eosinophilic gastroenteritis (EGE), and eosinophilic colitis (EC). The most common of these is EoE, affecting 1 out of every 2,000 people.

Our multidisciplinary team consists of pediatric gastroenterologists, dietitians, and consultative services by our allergists.

To schedule an appointment or refer a patient, please call: 843-876-0444. 

Eosinophilic Esophagitis (EoE)

What is EoE?

EoE is an allergic condition affecting the esophagus (the food tube that connects the throat to the stomach). Certain foods trigger an immune response leading to irritation in the esophagus. This irritation can produce symptoms.

What are the symptoms of EoE?

Symptoms may include: 

  • difficulty eating
  • nausea or vomiting
  • decreased appetite
  • gastroesophageal reflux (GERD)
  • abdominal pain
  • poor weight gain
  • In some cases, the inflammation is severe enough for food to get stuck in the esophagus.

Diagnosing EoE

In children, EoE is diagnosed by a Pediatric Gastroenterologist. Your doctor will inquire about symptoms and your medical history. Many children with EoE also have other allergic conditions, such as asthma, eczema, or environmental allergies.

Diagnosing EoE also includes an upper endoscopy, which is an outpatient procedure under sedation. A flexible fiberoptic scope is inserted into the mouth, down the esophagus, into the stomach, and part of the small intestine. Small tissue samples, called biopsies, are taken for review under the microscope to look for eosinophils. An eosinophil is a specific type of white blood cell involved in allergic processes, such as EoE.

What are the treatments for EoE?

There are several treatment options, which can be discussed with your physician.

Dietary Changes

  • Empiric Elimination Diet: removes the most common food triggers in EoE (cow milk, soy, egg, wheat, fish/shellfish, peanuts). This is called a 6-Food Elimination Diet. Over time, Food Trials of adding these foods back into the diet are performed under direction by your physician with a series of follow-up scopes to reassess if the addition of a particular food provoked return of eosinophilic inflammation in the esophagus.
  • Elemental Diet: highly refined specialty formula where proteins are already broken-down. This is more commonly used in infants or the most severe cases in older children. 

Prescription Medications

  • Proton Pump Inhibitors (PPIs) are effective in some individuals.
  • Swallowed steroids are effective, such as fluticasone or budesonide.
  • Dupilumab (Dupixent) was FDA approved for EoE on May 20, 2022 in patients 12 years and older. It is an injection given once a week.

Outcome

While medications and/or dietary treatment may lead to remission, this condition is life-long.

Resources

American Partnership for Eosinophilic Disorders https://apfed.org/
North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition https://gikids.org