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Eosinophillic Oesophagitis

This is a condition which often causes difficulty swallowing. On occasion it presents as bolus obstruction, wth food becoming trapped in the passage of the gullet and obstructing the swallowing of other foods and liquids. This can be very distressing. It is commonest in young men (age 20-40) but may present in women older people  and children. Sfferers often have a history of asthma or eczema in childhood.

There are classical appearances at endoscopy, which include the appearance of horizontal rings (felinisation) within the oesophagus. The classical appearances are not always present so it is important in anyone with bolus obstruction that oesophageal biopsies are taken since the diagnosis can only be made definitively on examination of the oesophageal lining under a microscopic. Biopsies are usually taken at lower, mid and upper oesophagus. Examination under the microscope usually demonstrates an excess of eosinophils (a pink inflammatory cell) within the mucosa. Eosinophils may be seen in mucosa of patients with gastro-oesophageal reflux as well, however their number and density are usually greater within the mucosa of patients with eosinophilic oesophagitis.

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