As a nutrition student I love chatting to people about nutrition related health issues. This week I met Hayley Anderson who delivers ‘Walking Away From Diabetes’ sessions at the Skelmersdale Community Food Initiative. Hayley a former Community Nurse, who studied at Edge Hill University, shared with me the story of her son Evan and the concerns she had about his digestive health, from an early age.
Hayley told me that as a baby Evan had suffered from recurring bouts of reflux, projectile vomiting and problems swallowing and how initially this was put down to possetting or common digestive problems.
Having trained as a nurse Hayley was able to question what she was being told by health professionals, and press for an endoscopy to investigate further. The endoscopy revealed that Evan was suffering from a severe case of Eosinophilic esophagitis (EoE) an allergic / immune condition which causes inflammation or swelling of the oesophagus which is the tube that sends food from the mouth to the stomach.
A 2013 study by Redd & Schey reported that the prevalence of EoE is said to have increased significantly over the past few years, however, it is unclear whether the prevalence is actually increasing or if health professionals are just recognising it more often.
The American Academy of Allergy Asthma and Immunology (AAAAI) outline that in EoE patients, large numbers of white blood cells called eosinophils are found in the tissue of the oesophagus, where there are normally none. EoE is said to occur at any age and most commonly occurs in Caucasian males.
The symptoms of EoE are said to vary with age:
- Babies and toddlers may refuse food or not grow properly.
- School-age children may suffer from recurring abdominal pain, vomiting or have trouble swallowing.
- Teenagers and adults most often have difficulty swallowing. The oesophagus can narrow to the point that food gets stuck and is called food impaction which is a medical emergency.The 2013 study referred to earlier, provides details of treatments such as the six food elimination diet which is the treatment being tried by Hayley and Evan. The diet is based on removing those foods groups with the most allergenic potential, namely, milk, eggs, soy, wheat, nuts, and seafood. This diet is less restrictive than elemental / formula diets and does not require the in-depth allergy testing necessary in specific food elimination diets. Studies in adults have shown varied results, which are possibly associated with the degree of compliance to the diet itself. There is evidence from one study of 35 patients with EoE, which found that 74 % of the patients showed improvements both clinically and histologically.
I was in a similar position to Hayley before my son was diagnosed coeliac disease, and like Hayley I just knew that there was something wrong and wouldn’t give up. Evan is very lucky to have Hayley as his mum, our concern is that other children may not be so lucky and be suffering unnecessarily.
For me as a Nutrition and Health student this case highlights the importance of ongoing Continuing Professional Development (CPD) and keeping up to date with new research findings.
Both Hayley and I say to parents everywhere you know your babies better than anyone else, so follow your instincts.
More information on EoE can be found on the following websites: http://www.apfed.org/drupal/drupal/index.php
Redd, M. & Schey, R. (2013) Eosinophilic Esophagitis: Current Treatment, Digestive Diseases and Sciences<spacer.gif>58.3<spacer.gif>