How To Diagnose Eosinophilic Esophagitis

Diagnosis of EoE is Done By having an Upper Endoscopy (EGD) Procedure

The diagnosis of eosinophilic esophagitis is suspected when dysphagia for food occurs, even though it is not among the most frequent causes of dysphagia. An EGD is also known as an Upper Endoscopy, which is a procedure in which a thin scope with a light and camera at its tip is used to look inside the upper digestive tract — the esophagus, stomach, and first part of the small intestine called the duodenum. This enables the doctor to see the internal lining of the esophagus (as well as the stomach and duodenum). Schatzki rings strictures, cancers, and usually achalasia, all could be diagnosed at the time of EGD.

Abnormalities that indicate eosinophilic esophagitis may be also seen by the physician. For example, some patients with eosinophilic esophagitis show narrowing in the majority of the esophagus. Others have a series of rings across the entire length of the sidewalk. However, others have furrows running up and down the esophagus and a few have small white stains on the bronchial lining that signify pus composed of dying mounds of eosinophils. The diagnosis of eosinophilic esophagitis is created with a biopsy of the inner lining of the esophagus. The biopsy is done by adding a very long lean biopsy forceps through a channel in the endoscope that divides off a sample of tissue in the inner lining of the esophagus. The tissue can be then examined by A pathologist under the microscope to search for eosinophils.

Oftentimes with eosinophilic esophagitis, the esophagus looks normal or will reveal only minor abnormalities. The diagnosis of eosinophilic esophagitis can be missed unless biopsies are taken of the esophagus. In reality, not carrying biopsies has led in certain patients using dysphagia for many years before the diagnosis of eosinophilic esophagitis is made, and doctors are now more likely to perform biopsies of the esophagus in individuals with dysphagia, even those with a normal-appearing esophagus, who don’t have any clear reason behind their dysphagia.

What to Expect During an Upper Endoscopy (EGD)?

The endoscopy is performed while you lie on your left side. Before the procedure, the physician will give a medication to numb your neck (possibly a gargle or a spray). There is a plastic mouth guard placed between your teeth to stop damage any potential damage to your teeth and the scope.

The endoscope (also called a gastroscope) is a slim, flexible tube that’s passed through the mouth down into your esophagus. The range has a lens and a light source that allows the doctor to see the lining of the gastrointestinal tract. The scope also blows air into the stomach; this expands the folds of tissue and makes it more easy for the physician. Most of us don’t have any difficulty swallowing the flexible gastroscope as a result of the drugs. A lot of men and women sleep during the test; others are relaxed and not aware of the examination.

The endoscopist may take tissue samples called biopsies (not painful), or perform certain treatments (such as dilation, removal of polyps, treatment of bleeding), determined by what is found during the examination.

How Long Does it Take to Recover?

Because you will be sedated, you will be observed by medical personnel for a couple of hours while the medication wears off. Most patients tolerate endoscopy very well and feel fine afterward. Some fatigue is common after the examination, and you should plan to take it easy and relax the rest of the day.

Video Resources