Differentiating Eosinophilic Esophagitis and Eating/Feeding Disorders

Area of Science:

• Gastroenterology
• Pediatrics
• Psychiatry

Background:

• Eosinophilic esophagitis (EoE) is an esophageal inflammatory condition causing dysmotility.
• Feeding or eating disorders (ED) can present with similar symptoms, yet literature is scarce.
• EoE and ED can co-occur, necessitating comprehensive patient evaluation.

Purpose of the Study:

• To highlight the symptomatic overlap between EoE and ED in pediatric patients.
• To emphasize the importance of considering both conditions in differential diagnoses.
• To guide clinical assessment and management strategies for overlapping cases.

Main Methods:

• Presentation of 4 pediatric cases from University of Rochester Pediatric Ambulatory Clinics in 2020.
• Analysis of patient histories and diagnostic processes.
• Review of symptomatology common to EoE and ED.

Main Results:

• Three patients initially presumed to have ED were diagnosed with EoE.
• One patient with prior EoE diagnosis was found to have a co-existing ED.
• Symptom overlap includes indigestion, acute weight loss, and dysphagia.

Conclusions:

• EoE symptoms can mimic those of EDs like anorexia nervosa or avoidant restrictive food intake disorder.
• Clinical assessment for EoE or ED should include inquiries about both conditions.
• Periodic evaluation for ED in EoE patients and vice versa is crucial for effective management.