PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Spurred by food allergies, 2 esophagus conditions stump doctors

2013-12-17
(Press-News.org) Contact information: Mark Derewicz
mark.derewicz@unch.unc.edu
919-923-0959
University of North Carolina Health Care
Spurred by food allergies, 2 esophagus conditions stump doctors

CHAPEL HILL, N.C. – Researchers at the UNC School of Medicine found that two on-the-rise esophagus conditions are so similar that even a biopsy is not enough to distinguish one disease from the other.

One condition is called eosinophilic esophagitis, or EoE. The other is PPI-responsive esophageal eosinophilia, or PPI-REE. Symptoms for each condition include difficulty swallowing, persistent heartburn, and getting food stuck in the throat. Both are diagnosed with an endoscopy, which reveals high numbers of a certain type of white blood cell – an eosinophil – in biopsies of both conditions. But finding a lot of white blood cells does not distinguish EoE from PPI-REE, said Evan Dellon, MD, MPH, associate professor of medicine and epidemiology and lead author of a study published in the American Journal of Gastroenterology.

Dellon says that both conditions can be the result of a food allergy, but they require different treatments.

Patients whose white blood cell count can be lowered by antacid medications, also called proton-pump inhibitor (PPI) medications, are diagnosed with PPI-REE. However, finding out if the white blood cell count was lowered requires a second endoscopy and biopsy. If the count remained high, then patients are diagnosed with EoE and require an anti-inflammatory medication, such as a steroid typically used to treat asthma.

"Unfortunately, right now the only way to differentiate between the conditions is to do the PPI medication trial and then repeat the endoscopy," Dellon said.

During his study, Dellon's team wanted to see if any symptoms, endoscopic views of the esophagus, or tissue samples could help him differentiate the two conditions so that future patients wouldn't have to go through an eight-week antacid trial and a second endoscopic biopsy, an invasive procedure that is safe but costly and requires sedation.

The study enrolled 223 patients with esophageal complaints. Dellon's team took small samples of tissue from the patients and examined them for the presence of eosinophils—white blood cells. Patients with a high eosinophil count were given an 8-week course of antacids. The study showed that approximately 30 to 40 percent of the participants responded to the antacid medication. They were diagnosed with PPI-REE.

Patients who did not respond to antacids were diagnosed with EoE. There are no FDA-approved medicines for EoE, so the steroids that doctors prescribe are considered off-label use. There are, however, several randomized, double-blind studies that show that these medications work for EoE.

"The other option for treating EoE is to try a variety of elimination diets to remove the most common food triggers, such as wheat, dairy, soy, or eggs," Dellon said. "We know that it's mostly an allergic reaction because if you take away all allergens, nearly everyone will get better very quickly. But that isn't a practical treatment for many people."

After rigorous analysis, Dellon and his colleagues did not find any clinical or endoscopic characteristics that could reliably distinguish the two conditions. This means patients will still need to undergo the PPI trial and repeat endoscopy in order to be properly diagnosed.

Dellon's team is working on an extension of this study that uses a special stain on the cell biopsies that he hopes will predict who will respond to antacids. Dellon also wants to investigate patient genetics as a possible diagnostic tool.

"This whole antacid response and even the existence of PPI-REE as a condition weren't really described well until two years ago," Dellon said. "So the diagnostics are still very much in flux right now."



INFORMATION:

This research was funded through a grant from the National Institutes of Health and a Junior Faculty Development Award from the American College of Gastroenterology. Evan Dellon, MD, MPH, associate professor of medicine in the UNC School of Medicine and adjunct associate professor of epidemiology in UNC's Gillings School of Global Public Health, won a Hettleman Prize for scholarship achievement in 2012.



ELSE PRESS RELEASES FROM THIS DATE:

Cellulose nanocrystals possible 'green' wonder material

2013-12-17
Cellulose nanocrystals possible 'green' wonder material WEST LAFAYETTE, Ind. - The same tiny cellulose crystals that give trees and plants their high strength, light weight and resilience, have now been shown to have the stiffness of steel. The nanocrystals might be ...

Research shows how household dogs protect against asthma and infection

2013-12-17
Research shows how household dogs protect against asthma and infection Study led by UCSF, U Michigan scientists points to changes in gut microbes Children's risk for developing allergies and asthma is reduced when they are exposed in early ...

ORNL devises recipe to fine-tune diameter of silica rods

2013-12-17
ORNL devises recipe to fine-tune diameter of silica rods OAK RIDGE, Tenn., Dec. 16, 2013 – By controlling the temperature of silica rods as they grow, researchers at the Department of Energy's Oak Ridge National Laboratory could be setting the stage for advances ...

A universal RNA extraction protocol for land plants

2013-12-17
A universal RNA extraction protocol for land plants New method will facilitate next-generation sequencing and comparative studies of gene expression RNA, a nucleic acid involved in protein synthesis, is widely used in genetic research to study patterns of gene expression in different ...

U-M tinnitus discovery opens door to possible new treatment avenues

2013-12-17
U-M tinnitus discovery opens door to possible new treatment avenues Disruption of timing from sensory nerves underlies 'ringing in the ears' that plagues millions, including many veterans ANN ARBOR, Mich. — For tens of millions of Americans, there's no such ...

Can a glass of wine a day keep the doctor away?

2013-12-17
Can a glass of wine a day keep the doctor away? UC Riverside-led team finds that moderate consumption of alcohol can improve immune response to vaccination RIVERSIDE, Calif. — It's the time of year when many of us celebrate the holidays with festive foods ...

Stanford researchers take a step toward developing a 'universal' flu vaccine

2013-12-17
Stanford researchers take a step toward developing a 'universal' flu vaccine Targeting the stem rather than the head of a critical protein is the challenging but promising tactic of a new study Every year the approach of flu season sets off a medical guessing ...

Minorities' health would benefit most from beverage sugar tax, UCSF researchers report

2013-12-17
Minorities' health would benefit most from beverage sugar tax, UCSF researchers report Taxing sugar-sweetened beverages is likely to decrease consumption, resulting in lower rates of diabetes and heart disease, and these health benefits are ...

'Automation addiction,' other airline flight issues could be mitigated by better user interface

2013-12-17
'Automation addiction,' other airline flight issues could be mitigated by better user interface Human factors/ergonomics experts conceptualize UI improvements that might prevent tragedy Amid news reports on the National Transportation Safety Board hearings regarding ...

Regenerative medicine: Mayo Clinic and collaborators develop new tool for transplanting stem cells

2013-12-17
Regenerative medicine: Mayo Clinic and collaborators develop new tool for transplanting stem cells ROCHESTER, Minn. -- Mayo Clinic researchers and colleagues in Belgium have developed a specialized catheter for transplanting stem cells into the beating heart. The novel ...

LAST 30 PRESS RELEASES:

AI algorithm based on routine mammogram + age can predict women’s major cardiovascular disease risk

New hurdle seen to prostate screening: primary-care docs

MSU researchers explore how virtual sports aid mental health

Working together, cells extend their senses

Cheese fungi help unlock secrets of evolution

Researchers find brain region that fuels compulsive drinking

Mental health effects of exposure to firearm violence persist long after direct exposure

Research identifies immune response that controls Oropouche infection and prevents neurological damage

University of Cincinnati, Kent State University awarded $3M by NSF to share research resources

Ancient DNA reveals deeply complex Mastodon family and repeated migrations driven by climate change

Measuring the quantum W state

Researchers find a way to use antibodies to direct T cells to kill Cytomegalovirus-infected cells

Engineers create mini microscope for real-time brain imaging

Funding for training and research in biological complexity

The Journal of Nuclear Medicine Ahead-of-Print Tip Sheet: September 12, 2025

ISSCR statement on the scientific and therapeutic value of human fetal tissue research

Novel PET tracer detects synaptic changes in spinal cord and brain after spinal cord injury

Wiley advances Knowitall Solutions with new trendfinder application for user-friendly chemometric analysis and additional enhancements to analytical workflows

Benchmark study tracks trends in dog behavior

OpenAI, DeepSeek, and Google vary widely in identifying hate speech

Research spotlight: Study identifies a surprising new treatment target for chronic limb threatening ischemia

Childhood loneliness and cognitive decline and dementia risk in middle-aged and older adults

Parental diseases of despair and suicidal events in their children

Acupuncture for chronic low back pain in older adults

Acupuncture treatment improves disabling effects of chronic low back pain in older adults

How interstellar objects similar to 3I/ATLAS could jump-start planet formation around infant stars

Rented e-bicycles more dangerous than e-scooters in cities

Ditches as waterways: Managing ‘ditch-scapes’ to strengthen communities and the environment

In-situ molecular passivation enables pure-blue perovskite LEDs via vacuum thermal evaporation

Microscopes can now watch materials go quantum with liquid helium

[Press-News.org] Spurred by food allergies, 2 esophagus conditions stump doctors