Feeding Difficulties in Children With Eosinophilic Esophagitis

Abstract

Eosinophilic esophagitis (EoE) is a recently recognized inflammatory disease that is characterized by upper intestinal symptoms and dense eosinophilia of the esophageal mucosa. Food refusal, dysphagia, and reduced volume and variety of intake are common symptoms associated with eosinophilic esophagitis in children (Furuta et al., 2007; Spergel, 2007). Accurate diagnosis of eosinophilic esophagitis is frequently missed as many of its features are similar to other gastrointestinal diseases (Aceves, Furuta, & Spechler, 2008). Oftentimes, before this diagnosis is made, a feeding specialist is the first contact for these children in response to their eating difficulties. Gastroenterologists, allergists, feeding specialists, dietitians, psychologists, and social workers are now collaborating to provide integrated, comprehensive care for optimal diagnosis and treatment of children with eosinophilic esophagitis. In the general population, feeding difficulties are present in 25% of typically developing children and in 75-80% of children with developmental disabilities (Eicher, 1997; Iwata, Riordan, Wohl, & Finney, 1982; Kedesky & Budd, 1998; Kerwin, Ahearn, Eicher, & Burd, 1995; Lefton-Greif & Arvedson, 2007). Although prevalence numbers for feeding issues in children with eosinophilic esophagitis are unknown, it is anticipated that the prevalence will fall closer to that of children with developmental disabilities.