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A Not-So-Simple Case: Inflammation of the Esophagus

  • [아시아뉴스통신] Timothy Montales 기자
  • 송고시간 2018-02-27 20:30
  • 뉴스홈 > 국제
Photo by: skeeze via Pixabay
 

Playing sports, particularly those that involve a lot of running, can make one catch his/her breath, not to mention, hungry.


So, one time in between football practice, 14-year-old Alec Hebblethwaite from Missouri in the midwestern US thought of having a piece of cracker.After eating it, what happened next was oddly unexpected: he vomited blood, reported British news site, The Sun.


His mother rushed him to the hospital, and the medics at the emergency room informed the worried mom that the cracker scratched her teenage son’s esophagus, that part of the human body where food passes from the throat down to the stomach.


They advised her to have him eat soft food instead to avoid a similar incident.


A month passed and one day, the mother-and-son tandem went to Walmart for a snack, with Alec picking a ham and cheese sandwich.


This time, the poor kid choked on it and experienced chest pain, and that was “when all this craziness happened,” quoting the mother as she narrated her son’s condition through You Caring, an online fundraising platform.


If the previous eating incident scratched his esophagus, doctors at the hospital told her that this time, it got slit, creating a hole in it.Alec got confined to the intensive care unit for 106 days, according to Daily Mail Online.


Seven months after throwing up blood, these two words finally enlightened Alec’s family about his true condition: eosinophilic esophagitis.


What is EoE?


Eosinophilic esophagitis, basically, is an inflammation of the esophagus.


When one experiences this condition, the tissues of that person’s esophagus are filled with a large number of eosinophils (e-o-SIN-o-fils), according to the American Academy of Allergy, Asthma, and Immunology.


Under normal circumstances, the esophagus should be free of any of this type of white blood cells.


Symptoms of EoE depend on a person’s age.


     - For infants and toddlers (1-4 years old), they appear not to be growing and that they tend to refuse being fed.


     - For school-age children (6-12 years old), they may regularly complain of having trouble swallowing or of frequent abdominal pain.They may also be several instances of vomiting.


    - For teenagers and adults, they also find it hard to swallow, specifically solid food items.The worst thing that could happen at this point is food impaction -- the food got stuck in the esophagus because it became so narrow already.Such incident is regarded as a medical emergency.


Generally, the symptoms, according to Mayo Clinic, are:


     - (while eating) chest pain behind the breastbone


     - difficult or painful swallowing


     - heartburn (there’s a painful burning sensation in your throat or chest)

 


An example of an endoscope / Photo by: Kalumet via Wikimedia Commons



 


Heartburn is a symptom of acid reflux, a condition when the body has too much stomach acid in it.To reduce gastric acid production, the drugs called proton pump inhibitors  (PPIs) are prescribed.


Mayo Clinic also stressed the importance of drinking water after swallowing a pill (e.g., pain-relieving pills for headaches or stomach aches) to prevent residues from that pill to remain in the esophagus.


Here are some drugs that could cause EoE:


     - antibiotics (doxycycline and tetracycline -- both are used to treat cholera and syphilis)


     - aspirins


     - bisphosphonates (for osteoporosis)


     - ibuprofen (usually taken by those having their menstrual period or experiencing migraine or rheumatoid arthritis)


     - naproxen sodium (for pain relief, common brands: Anaprox, Naprosyn)


     - potassium chloride


     - quinidine (for heart problems)


How to Diagnose EoE


People in the field of medicine who look into EoE patients are gastroenterologists, allergists, immunologists, and pathologists.


To examine the esophagus, the patient must undergo endoscopy.In this procedure, a long, flexible tube (the endoscope) will be inserted through the mouth, down to the throat, and then into the esophagus to examine its internal parts.They can be viewed because attached to the tube is a tiny camera.


Another medical test that could be conducted is a biopsy, where a sample tissue will be taken for closer examination.


Atopic people -- those who have the tendency to develop allergic diseases -- are more likely to have EoE, such as those who have food and environmental allergies (allergic from pollens, dust mites, molds, or animals).


An allergist will require the patient to take these tests: blood tests, prick skin testing, and food patch tests.


How to Treat EoE


The usual medications are PPIs and, if the patient will not respond to them, then topical steroids will be prescribed, such as budesonide (sample brand name: Pulmicort) and fluticasone.The former is available in pill form or as a nasal spray or inhaler.Patients should not worry about experiencing the typical side effects associated with steroids (e.g., acne, weight gain, and difficulty in sleeping) because the two mentioned do not go into the bloodstream.


Another is dietary therapy where, upon doctor’s orders, the patient will refrain from eating certain food items.

 


Photo by: patrik_h via Pixabay
 

The problem with EoE is that it is a chronic condition.Meaning, it’s persistent and can go back at any given time in the future.


Food and Beverages to Avoid When Diagnosed with EoE


     - alcoholic drinks


     - caffeinated beverages (coffee, soft drinks)


     - chocolates


     - citrus fruits (lemons, limes, grapes, oranges, pomelo)


     - garlic and onions


     - mint-flavored food


     - spicy food