Your Eosinophilic Esophagitis and Asthma Action Plan

At first glance, eosinophilic esophagitis (EoE) and asthma may seem like two very different conditions. The former causes inflammation in the esophagus, leading to trouble swallowing, while asthma affects the lungs and airways, triggering symptoms such as wheezing and shortness of breath.

If you have both conditions, the connection can feel confusing, especially when symptoms overlap or flare at the same time. But understanding their interplay and the differences and similarities in symptoms and treatment can help you navigate both.

With EoE, white blood cells called eosinophils are associated with inflammation in the esophagus. Those same white blood cells are also concentrated in the airways of people with asthma and associated with allergic reactions.

“Like eosinophilic esophagitis, sometimes asthma reflects an allergic disorder,” says Jimmy Johannes, MD, a pulmonologist and critical care medicine specialist at MemorialCare in Long Beach, California. “In EoE, the allergic response affects the esophagus, while in allergic asthma, the allergic response affects the bronchial tubes of the lungs.”

Another way these conditions are linked sometimes is by their symptoms and triggers. “For those with comorbid EoE and asthma, these triggers are often aeroallergens, such as pollen, or food allergens,” says Dr. Johannes.

If you have both EoE and asthma, it’s important to note that some symptoms overlap. For instance, says Johannes, you could cough due to asthma, EoE, or GERD. Chest tightness, another hallmark symptom of an asthma attack, could occur because of an esophageal spasm from EoE.

EoE and asthma are two separate conditions that require different treatments. “EoE usually involves treatment of the esophagus, whereas treatment for asthma typically involves inhalers, which are directed to the bronchial tubes of the lungs,” says Johannes. But there are some medications, such as biologics and corticosteroids, that can help both conditions by targeting allergic inflammation, he notes.

You’ll likely need to see a gastroenterologist for EoE management, as well as an allergist, who can help you manage medication and identify any triggers.

If you have asthma, it’s important to have an asthma action plan in place. This should involve inhalers and possibly systemic steroids, he says. “It’s not typically different for someone who also has EoE, but because some of the medications used for asthma can also be used to treat EoE, these nuances may need to be reviewed with the treating physicians.”

• EoE and asthma are closely connected. Even though one affects your esophagus and the other, your lungs, both are driven by allergic inflammation and involve the same immune cells.
• Symptoms and triggers can overlap. Coughing, chest tightness, and acid reflux can come from either condition — or both. Common triggers, including food allergens, GERD, and pollen, may worsen EoE and asthma at the same time.
• Managing both EoE and asthma takes a team approach. The conditions require different treatments, but some medications can help control both. Working with a gastroenterologist, pulmonologist, and possibly an allergist can help ensure all of the symptoms are handled effectively.