What Goes Down the Hatch

Rare food allergy disease has new test as semi alternative to endoscopy

(RxWiki News) Food allergies can be scary. On top of that, a rare food allergy disease is making it more difficult to swallow, so what can be done to watch for it?

A new testing technique helps monitor for eosinophilic esophagitis, according to a recently published study.

"Talk to an allergist about food allergies."

In the disease, called EOE for short, inflammatory cells in the body attack the esophagus.

As a result, this pathway connecting the mouth to the stomach narrows until food cannot pass.

Though it's very uncommon, researchers say this food-allergy disease is popping up more often in the population and can be found in both children and adults.

"Most cases are first encountered in the emergency room, where a child is brought in because something he ate is caught in his esophagus," said Steven Ackerman, UIC professor of biochemistry and molecular genetics and co-principal investigator on the study, in a press release.

Researchers from the University of Illinois at Chicago College of Medicine worked with investigators from the University of Colorado Denver/Children's Hospital Colorado and Lurie Children's Hospital in Chicago to create a simpler test to diagnose the inflamed esophagus disease.

The study included 41 patients between 7- and 20-years-old who were having endoscopy and biopsies done on their esophagus.

The new test uses a capsule containing a 1-yard long string that is taped to the patient's cheek before the capsule is swallowed.

As the capsule is dissolved, the string unravels and stretches through the esophagus, stomach and small intestine.

When the string is removed for analysis, it is coated with secretions from the digestive tract.

In the study, participants swallowed the capsule the night before having the endoscopic procedure, and the string was removed just before having it done.

The researchers say the string may not need to stay in place for long and the test could be performed all in one visit.

The test "certainly has the potential to significantly improve the evaluation and treatment of patients who require repeated assessments," the authors said in a press release.

They said that right now the string test by itself might not be enough to replace the typical procedure that tests the disease in patients.

In that procedure, a lighted, flexible instrument is sent down the esophagus to obtain tissue samples along the throat to the stomach so physicians can check for EOE.

A child may need up to 20 of these procedures over three or four years, according to two of the authors, Glenn Furuta, professor of pediatrics at the University of Colorado at Denver, and Amir Kagalwalla, associate professor of pediatrics at Northwestern University.

With each procedure, six to eight tissue samples are taken.

John Oppenheimer, MD, a pulmonary and allergy specialist and dailyRx Contributing Expert, says he looks forward to seeing how the new testing tool will work in future studies.

"The use of this less invasive string test represents a less invasive tool," he said.

"If proven, this will be a great step forward in the care of EOE patients."

The authors do not declare any competing interests.

This study was supported by grants and gifts from a number of institutions, including NIH, Thaser Research Fund, Colorado CCTS, Shell, Mandell, Boyd and Savoie Families, American Gastroenterological Association, Campaign Urging Research for Eosinophilic Diseases, Buckeye Foundation, Pappas Foundation, American Partnership for Eosinophic Disorders, Sandhill Scientific and Mayo Foundation.

The study was published online August 15 in the journal Gut by the British Medical Journal Publishing Group.

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Review Date: 
October 10, 2012