Eosinophilic Esophagitis Clinic
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Gastroenterology Referrals
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The CHOC Eosinophilic Esophagitis Clinic is one of only a handful of multidisciplinary clinics dedicated to treating all of the symptoms of eosinophilic esophagitis (also known as EoE) in Southern California. Our team of gastroenterologists, allergists and dietitians work with patients and families to help diagnose and treat EoE.
When a child is first diagnosed with EoE, it can be an overwhelming experience. We provide the expertise and support needed to manage the patient’s health and wellbeing. The clinic meets every first and third Wednesday of the month. During the initial stages of care, patients may need to attend clinic every one to three months depending on the severity of the child’s symptoms. The EoE team also provides support services outside of the clinic through e-mail and telephone calls. Once there is resolution of the EoE and the trigger is identified, we recommend yearly visits for follow-up.
Understanding EoE
When a child is first diagnosed with EoE, it can be an overwhelming experience. We provide the expertise and support needed to manage the patient’s health and wellbeing. The clinic meets every first and third Wednesday of the month. During the initial stages of care, patients may need to attend clinic every one to three months depending on the severity of the child’s symptoms. The EoE team also provides support services outside of the clinic through e-mail and telephone calls. Once there is resolution of the EoE and the trigger is identified, we recommend yearly visits for follow-up.
There are many terms, tests, and treatments that you may hear about during your visit. Browse the EoE glossary so better understand what your specialist may reference during your appointment.
Diagnosing EoE
Currently, the only way to make a diagnosis of EoE is by an endoscopy with biopsies of the esophageal lining. During an endoscopy, a gastroenterologist inserts a small tube with a camera located at the tip into the mouth, down the esophagus, and into the stomach and first part of the small intestine. The doctor will look at the tissue lining of the gastrointestinal tract and take small pieces of tissue called biopsies. During the endoscopy, the gastroenterologist will also look for any changes in the appearance of the esophagus, including white blotches, long white lines (called linear furrows) or rings. After the biopsies have been taken, a pathologist will look at the small samples of tissue under the microscope and count the number of eosinophils (allergy cells) in a set area.
Treating EoE
There is no exact cure for eosinophilic esophagitis (EoE). Because every patient’s case is different, the CHOC Eosinophilic Esophagitis Clinic’s team of gastroenterologists, allergists and dietitians works together to develop the best course of treatment for each patient based upon their history and response to prior treatments. Often, treatment plans will need to be altered as doctors and other specialists monitor the patient’s progress. EoE may be treated through food avoidance and/or through the use of medications. When changing the diet does not correct a child’s eosinophilic esophagitis (EoE) symptoms or following a strict diet is not feasible, our staff may look to place a child on medications that can help with the EoE symptoms. The CHOC Eosinophilic Esophagitis Clinic is always working with drug companies and researchers to find better alternative treatments for EoE.
Our goals for every patient are:
- Symptom resolution
- Clear biopsy
- Prevention of future complications
- Maintaining quality of life
Pinpointing what is causing a child’s EoE may be a challenging journey. It will take time to walk through each step of the work-up, treatment and trial periods. Every child is important to us, and we make every effort to be available to help patients and their families through the process. Because each child is different, so are the treatment options.
Clinical Trials
CHOC is a leader in the diagnosis and treatment of EoE. Our team of allergists and gastroenterologists is involve
The CHOC Eosinophilic Esophagitis Clinic is proud to offer a multidisciplinary team approach to the treatment of eosinophilic esophagitis (EoE). The team collaborates to meet the unique needs of each patient and family by developing specific treatment plans that are individualized for each patient.
Gastroenterology Doctor and Nurse Practitioner
Many of the first symptoms patients with EoE experience are in the gastrointestinal area of the body, also known as the digestive system. Because of this, a member of the GI team has usually seen most patients before they are diagnosed with EoE. Once an upper endoscopy is completed and the gastroenterologist confirms the signs of EoE, patients are referred to our clinic. Our nurse practitioner coordinates the care between the gastroenterologists and the remainder of the team. She sees every patient at every clinic visit and regularly communicates all information regarding each patient to the physician who originally saw the patient.
Allergist
EoE is an allergic disease. The allergist is essential in figuring out which allergy is causing the EoE symptoms. An allergist performs the initial allergy work-up and testing. Once all the testing is finished, the allergist works with the patient, his or her family and the clinic’s dietitian on food elimination and reintroduction.
Dietitian
Because food elimination is necessary to determine which specific foods are causing a child’s EoE, our dietitian closely monitors our patients to ensure they are getting the proper nutrition they need to grow and develop. The dietitian provides education and support while following elimination or elemental diet therapies and suggests alternative foods or specialized formulas to meet the child’s nutritional needs.
Medical Assistant
The medical assistant helps administer allergy testing in the clinic and assists the physician in interpreting the results. She provides allergy and asthma education to patients and their families, which includes instructions about environmental changes as well as the use of prescribed medications and information on action plans prepared by the physician. The medical assistant has also been very important in the success in obtaining authorizations and coverage for elemental formulas.