With the rise of eosinophilic esophagitis being diagnosed in the United States, there likely is a contributing factor. This is evidenced from twin studies that show stronger disease concordance in twins compared with non twin siblings, suggesting that early-life factors contribute. Studies have shown that environmental factors account for nearly 85% of the disease cause. A recent study published in The Journal of Allergy and Clinical Immunology, looked at the risk factors for eosinophilic esophagitis. Investigators sought to determine the association between prenatal, intrapartum and postnatal factors in the development of eosinophilic esophagitis.
The following was observed:
- Prenatal (maternal fever, preterm labor) was associated with increased risk.
- C-section delivery was associated with a 77% increased risk for Eosinophilic Esophagitis.
- Antibiotic use in infancy was associated with a 130% increased risk.
- Use of acid suppressors in infancy was strongly associated with risk of Eosinophilic Esophagitis
- Presence of furred pets in infancy was protective for Eosinophilic Esophagitis.
It is apparently not associated with breast-feeding, maternal multivitamin or folic acid supplement use.
Patients with eosinophilic esophagitis often have other atopic comorbidities (asthma, allergic rhinitis), respond to elimination diets, relapse on food re-exposure and have an allergic TH2 response in the esophagus. All of this suggests that the disease is allergen related.
This study shows that many of the factors identified are potentially modifiable and are areas for prevention.
It is important that if you are diagnosed with eosinophilic esophagitis that your gastroenterologist and allergist work together to tailor the best treatment approach. There are multiple diagnostic tests and treatment options that are available for patients with this disease.
To read more about factors for eosinophilic esophagitis and treatment options, please click on the links below.
There are several current studies underway for medications that target the production of eosinophils. IL-5 is a major target of these drugs, there are currently 3 on the market.