Dear Lactnet Friends:

Eosinophilic esophagitis (eosinophilic oesophagitis) is an allergic
inflammatory condition of the esophagus. Symptoms are swallowing
difficulty, food impaction, and heartburn. The disease was first described
in children but occurs in adults as well.

It requires biopsies of the esophagus for diagnosis. Those kids that are
still having allergic symptoms after mamma has eliminated foods should be
worked up for this. Note that antibiotic use, formula or partial
breastfeeding, and cesarean section are risk factors.

Geez, practically every baby born in the usa!

J Pediatr Gastroenterol Nutr. 2013 Mar 19. [Epub ahead of print]

Early Life Exposures as Risk Factors Forpediatric Eosinophilic Esophagitis:
A Pilot and Feasibility Study.

Jensen ET, Kappelman MD, Kim HP, Ringel-Kulka T, Dellon ES.
Source
*Department of Epidemiology, Gillings School of Global Public Health,
University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
†Division of Gastroenterology and Hepatology, Department of Pediatrics,
University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
‡Center for Esophageal Diseases and Swallowing, Division of
Gastroenterology and Hepatology, Department of Medicine, University of
North Carolina School of Medicine, Chapel Hill, North Carolina §Department
of Maternal and Child Health, Gillings School of Global Public Health,
University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Abstract

OBJECTIVES:: Few etiologic studies of eosinophilic esophagitis (EoE) have
been conducted. Early life exposures have been shown to predispose to other
allergic disease, but their role has not been assessed in EoE. This study
sought to explore early life exposures as possible risk factors for
developing EoE in the pediatric population.

METHODS:: This was a two-phase case-control study conducted at the
University of North Carolina. The first phase consisted of survey
development for early life exposures via cognitive interview. In the second
phase, atelephone-based questionnaire was administered to EoEcases (n = 31)
and two sets of controls, gastroesophageal reflux disease patients and
siblings of non-syndromic cleft lip/palate patients (n = 26 in each).
Different controls were explored to identify controlsreflective of the
source population of the cases. Siblings of cleft lip/palate patients were
identified as the more suitable control population. Odds ratios were
calculated to evaluate the association between early life exposures andthe
development of pediatric EoE.

RESULTS:: Early life exposures were associated with increased odds of
developing pediatric-onset EoE. Antibiotic use in infancy was associated
with 6 times the odds of having EoE (95% CI: 1.7-20.8). Cesarean delivery,
preterm birth, and formula-only or mixed (infant formula and breast milk)
feeding also had trends towards increased odds for developing EoE.

CONCLUSIONS:: A number of early life exposures may be associated with the
development of EoE. These are potentially modifiable risk factorsthat if
confirmedwould have implications for improvedunderstandingof
EoEpathogenesis and disease prevention.

warmly,

-- 
Nikki Lee RN, BSN, Mother of 2, MS, IBCLC, CCE, CIMI, ANLC, CKC
Author:* Complementary and Alternative Medicine in Breastfeeding Therapy*
www.breastfeedingalwaysbest.com
https://www.facebook.com/nikkileehealth

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