Question:

Good morning. For about two years I have been suffering from retrosternal pain and difficulty swallowing, which does not improve even with two 40 mg tablets of pantoprazole plus Gaviscon.
I have undergone several tests: coeliac disease antibodies, colonoscopy, esophageal manometry, 24-hour gastric pH monitoring with a probe, and gastroscopy with gastric biopsies for the removal of polyps. Everything was normal, apart from mild gastritis.
The gastroenterologist who is following me says that there is nothing wrong, while two other specialists I consulted told me that it could be eosinophilic esophagitis.
My question is: should this not have been seen during the gastroscopy I already had?
Thank you.

Answer:

In the diagnosis of eosinophilic esophagitis, histological assessment of esophageal biopsies is also essential.
Therefore, given your symptoms, it is important to assess whether eosinophils are present in the esophagus before definitively excluding a diagnosis of EoE.
In any case, we recommend that you discuss this with a gastroenterologist who is specialised in the management of this condition.

dott. Salvatore Oliva (UOC di Gastroenterologia ed Epatologia Pediatrica Dipartimento di Pediatria Sapienza – Università di Roma)​

Please remember that the answers provided are opinions and do not constitute medical advice. They cannot replace a consultation, a medical examination, or the review of the patient’s medical documentation.