Surge in Rare Inflammatory Condition: Unmasking the Threat of Esophageal Asthma

Characterised by difficulty swallowing and potential food obstructions, Eosinophilic Oesophagitis (EoE), often called 'asthma of the oesophagus', is a rare inflammatory condition that has seen a rapid rise in diagnostic rates.

Understanding Eosinophilic Oesophagitis

EoE is an inflammatory condition where the lining of the oesophagus becomes chronically inflamed, causing difficulty in swallowing and sometimes leading to food being lodged in the throat. The condition is driven by an excessive immune reaction. This involves specialised white blood cells called eosinophils, which are typically responsible for eliminating harmful intestinal bacteria and parasites.

'It can stretch more than three times its width to accommodate particularly large chunks of food'

Similar to the likes of asthma, eczema, and food allergies, instances of EoE are on the climb, without a singular clear-cut reason.

The Oesophagus: A Critical Digestive Organ

• The oesophagus is the muscular pipe that transports food from the mouth to the stomach. While it's usually less than a centimetre wide when at rest, it can stretch more than three times its width to allow larger chunks of food to pass through.
• Patients of EoE, however, experience a stiff, swollen oesophagus that isn't able to extend sufficiently, thereby prone to food blockages.

Why the Increase in EoE Cases?

The rise of EoE has been attributed to various factors, mirroring those of rising allergy and asthma cases:

• Modern cleanliness leading to fewer childhood infections, thereby weakening the immune system.
• Prolonged exposure to modern diets and common chemicals like pesticides and detergents that can inflict damage to the sensitive cells in the oesophagus.
• Increased consumption of highly processed foods containing additives, preservatives, sweeteners, and emulsifiers.

Diagnosis Challenges

EoE typically takes an average of six years to be correctly diagnosed due to limited awareness among GPs. This issue lets EoE progress to stages where patients may experience thick scarring throughout their oesophagus, inhibiting their ability to eat normally.

Advancements in Health Testing

A testament to the importance of health testing is the ongoing research on diagnosing EoE more conveniently. While traditional diagnostic procedures involve a full endoscopy - inserting a thin tube with a small camera down the patient's throat - newer methods are being developed. For instance, Cambridge-based gastrointestinal health company, Cyted, received funding in December to expand the use of its EndoSign capsule sponge test, a less invasive and equally accurate method of diagnosing EoE.

The Role of Diet and Lifestyle Changes

While medicines like budesonide (brand names include Jorveza) have proven highly effective, lifestyle changes may also play an important part in managing EoE. Patients are often advised to avoid certain foods, such as cow's milk, wheat, and eggs, which could potentially exacerbate the symptoms. Similarly, highly processed foods, sugar, and trans fat may contribute to the inflammation driving the disease and hence, are advised against.

The Patient's Perspective

Living with EoE can be challenging. It becomes center stage in a person's life, pressing them to avoid specific foods along with inciting anxiety around eating, particularly in social situations. A prompt diagnosis combined with the right treatment can make a significant difference, levelling up a patient's quality of life.

In conclusion, advances in health testing and increasing awareness of EoE among general practitioners hold the key to ensuring timely diagnosis and treatment of this rising health concern.