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What is the Difference Between GERD and Eosinophilic Esophagitis?

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Updated September 11, 2009

Question: What is the Difference Between GERD and Eosinophilic Esophagitis?
Many of the symptoms experienced by people with GERD and eosinophilic esophagitis overlap. While the symptoms are similar, the treatments are different. Are you being treated for GERD, though you really have eosiinophilic esophagitis?
Answer:

The following is a list of the shared symptoms between GERD and eosinophilic esophagitis:

  • nausea
  • vomiting
  • abdominal pain
  • chest pain
  • difficulty sleeping

The differences between GERD and eosinophilic esophagitis become apparent by looking at the etiology (cause or origin) of the disorders. While GERD is associated with a reflux problem, the cause is unknown in eosinophilic esophagitis. Research, however, shows that allergies and immune system responses are possible causes of eosinophilic esophagitis.

Both GERD and eosinophilic esophagitis have involvement of eosinophils in the esophagus. The difference can't really be diagnosed until a biopsy is performed. A small amount of tissue from the esophagus is taken during a procedure called an EGD. Using a high-powered field on a microscope, a count of 15 eosinophils throughout the esophagus is consistent with eosinophilic esophagitis. A count of less than 10 eosinophils at the distal (lower portion) of the esophagus is consistent with GERD.

One of the treatments of choice in GERD is the use of proton pump inhibitors like Protonix, Prilosec, or Prevacid. These medications, however, do not prevent the symptoms in eosinophilic esophagitis; the pH of the stomach is normal in these cases, unlike the pH associated with GERD.

Important Takeaway

Most GERD-like symptoms are indeed caused by GERD. There may be some people with GERD that are unresponsive to therapy who actually have eosiinophilic esophagitis. Those with the latter are usually diagnosed after a delay, as the disease is rare and symptoms overlap with far more common problems. Eosiinophilic esophagitis is not fatal.

Sources:

American Partnership for Eosinophilic Disorder. About EE. Accessed: September 7, 2009 from http://www.apfed.org/ee.

Nonevski, I.T., Downs-Kelly, E. & Falk, G.W. (2008). Eosinophilic esophagitis: An increasingly recognized cause of dysphagia, food impaction, and refractory heartburn. Clevland Clinical Journal of Medicine. Vol. 75(9): pp 623-633. Accessed: September 7, 2009 from http://www.ccjm.org/content/75/9/623.full]http://www.ccjm.org/content/75/9/623.full.

The Academy of Otolaryngology – Head and Neck Surgery. Fact Sheet: Gastroesophageal Reflux (GERD). Accessed: September 7, 2009 from http://www.entnet.org/HealthInformation/WhatIsGERD.cfm.

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