- Eosinophilic oesphagitis is a condition that is increasingly being recognized - perhaps increasing in frequency in the last 20 years
- This condition is a type of allergic condition where this is increased stiffness of the oesphagus leading to difficulty swallowing. This is the main cause of food bolus obstruction - the complete blockage of the oesphagus from food - usually meat or bread.
- This condition is diagnosed by gastroscopy and biopsy of the oesophagus
- The initial approach should be regular omeprazole or pantoprazole even if there are no symptoms of heartburn as acid can be the initiating factor for this allergic reaction. The next treatment is topical steroids. This can be achieved by using a high dose steroid inhaler (as used for asthma) and attempting to swallow rather than inhale the medication. Other solutions using budesonide liquid mixed with a viscous agent work - not available in NZ.
- Other treatments are being developed. Dietary exclusions based on elimination of common foods that cause allergy or based on allergy testing can be effective for children but much less effective in adults