Lourdes Physician Seeing Increasing Cases of ‘Asthma of the Esophogus’
Depford Resident Shares Experience of Living with Condition Nearly 20 Years
CAMDEN, NJ – Name any event – birthdays, weddings, Super Bowl – and food is a part of the celebration.
But for 42-two-year-old Deptford resident Michael Craig, who suffers from a condition called eosinophilic esophagitis, food is the cause of physical pain and social embarrassment.
“I often get the feeling that food is ‘stuck’ in my throat,” says Craig. “It doesn’t happen every time I eat, but it can happen at any time, so I must always be on alert. The only way the food will pass is if I vomit.”
According to Brian Berberian, MD, a gastroenterologist with Our Lady of Lourdes Medical Center, eosinophilic esophagitis is something he is seeing more of in patients. He says it is thought to be associated with allergies. “I call it asthma of the esophagus. Eosinophils, a type of white blood cell, are found in large numbers in the lining of the esophagus with this condition and with asthma and allergies like hay fever, allergic rhinitis and atopic dermatitis. Patients who have this condition are more likely to have allergies.”
The major symptoms of eosinophilic esophagitis include difficulty swallowing, also called dysphagia, and a burning sensation in the chest. Because these symptoms are similar to heartburn, many patients go misdiagnosed and can suffer for years.
That was the case for Craig. He first experienced a sensation of food being stuck in his throat while stationed on a Navy ship in1994. At the time it happened, he thought what he ate “went down the wrong pipe.” But after four repeated instances within the next few months, Craig sought medical help. Since then, he had monthly and sometimes weekly episodes but was continually given a diagnosis of either having stress or acid reflux. He was prescribed medication but nothing worked.
“I learned to live with it but it’s incredibly hard in social situations,” says Craig. “The low point for me was being at my daughter’s wedding in Hawaii and not eating. I knew it could potentially embarrass her and I’d have to leave immediately. It wasn’t worth the risk. Thankfully, it wasn’t long after that I found Dr. Berberian.”
Diagnosis of eosinophilic esophagitis is usually made during an endoscopy, when a physician inserts a flexible tube through the mouth and into the esophagus, says Dr. Berberian. A small sample of tissue taken from the lining of the esophagus can determine the presence of the condition.
Treatment typically involves medications to make swallowing easier, including oral steroids (Flovent) and proton pump inhibitors (such as Nexium, Prevacid or Prilosec). If medication fails, a procedure can be performed to gently widen the esophagus. Dr. Berberian also suggests patients consult with an allergist.
Dr. Berberian performed two endoscopies with dilation on Craig, and was able to confirm the condition. Craig now takes medication that includes an inhaler, antacids and steroids. He is also scheduled to see an allergist.
“It was a relief finally knowing after all these years,” says Craig, who is allergic to penicillin but does not have any known food allergies. “I was especially thankful that Dr. Berberian didn’t go along with what everyone else said. I felt as if we could now do something about it.”
“When solid food sticks in the esophagus, it causes a very uncomfortable sensation,” explains Dr. Berberian. “The chest pain can even mimic a heart attack. If the individual cannot dislodge the food by vomiting, an emergency endoscopy is required.”
Dr. Berberian says most of his “asthma of the esophagus” patients are in their mid-teens to 30s. For unknown reasons, men are more commonly affected by the condition than women, and it is most commonly found among young boys and men. In children, the most common symptoms are abdominal pain, nausea, vomiting and coughing.
“I’ve lived with it for so long, I know the routine – it helps if I don’t drink anything before eating and cut up my food into baby-sized portions,” says Craig. “I also chew my food for a very long time. But I’m looking forward to the future and getting relief from the physical and emotional pain the condition has brought me.”
Dr. Berberian says researchers are not sure of the exact substance that causes the reaction, including whether it is inhaled or ingested. “Some people live in fear of eating because they worry the food will get stuck. But help is available. I advise those suffering to see a physician.”