Treatment for Eosinophilic Esophagitis: Esophageal Sponge

By Sara Pepitone

In the late 1990s when eosinophilic esophagitis—EoE—was first described as a chronic, inflammatory disease of the esophagus, it was considered to be rare. Today, it’s known that up to 4 in 10,000 people worldwide have EoE, yet the average time for symptomatic patients to get a diagnosis is seven years.

“A lot of people and a lot of doctors still don’t think about this disease as a cause of swallowing trouble,” says gastroenterologist David Katzka, MD. “Many patients are told they have stress and anxiety, but there’s a very real reason why these people are feeling this way.”

Characterized by esophageal dysfunction and inflammation, EoE is triggered by an abnormal immune response to food and possibly environmental factors in the air, such as pollen or mold. People with EoE have large amounts of eosinophils—a trait of allergic diseases—in their esophagus. Inflammation causes the esophagus to narrow, and patients have trouble with swallowing, food impaction, vomiting, chest pain, failure to thrive (particularly in children), and mental distress. EoE also can lead to fibrosis, intestinal barrier dysfunction, and other conditions. 

Dr. Katzka, professor of medicine, has been studying EoE for nearly 25 years, propelled by struggling patients and a desire to learn more about the disease. He has pioneered the use of an esophageal sponge to identify EoE triggers and guide treatment. The sponge also takes the place of endoscopy and sedation in many EoE procedures and can be done in the office in just five minutes. 

“EoE patients need many endoscopies, particularly when determining what is the best form of therapy for them,” says Dr. Katzka. “They overwhelmingly prefer the sponge not only because it reduces risk but also because they don’t have to take a day off from work and arrange for people to pick them up.”

Until Dr. Katzka arrived at Columbia in 2021, no gastroenterologist in the tri-state area specialized in adult EoE. Now Columbia is one of only two places in the United States where EoE patients are offered the sponge for monitoring and is the only center in the tri-state area for adult patients. Dr. Katzka and his team work closely with allergists, nutritionists, and endoscopists to co-manage patients. 

Because no cure exists for EoE, pediatric EoE patients are destined to become adult patients. The team created a pediatric-adult EoE transition program for kids with EoE.

More information and appointments: columbiadoctors.org