Since he was little, Nahuel had problems. Food allergies, colds, breathing difficulties that caused hospital admissions… But according to the tests, many, everything was fine. If there was any illness, he was invisible. The situation deteriorated to the point that he could not swallow food and felt constant pain in his chest. The boy was 10 years old and that was when the disease showed its face: an endoscopy reported the deterioration of the esophagus and the biopsies pointed to the origin of everything, eosinophilic esophagitis (EoE). Remember this intricate name, because it is a food allergy that in 30 years has gone from non-existent to being one of the fastest growing. It is a disease of the modern era, and specialists maintain that there are many people who suffer from it without knowing it.
Nahuel had a hard time assimilating it. It took him a year to tell his friends, his parents sought psychological support to help him. Two years after the diagnosis, he has understood the situation. After all, he can lead a normal life, without any limitations in studies or playing sports, except that he is subject to numerous dietary restrictions. In his case, no trace of gluten, fish or milk proteins.
“The rest of us eat to be able to live, for them it seems that eating takes their life,” explains their mother, Zoraida Gómez, about the times before the diagnosis. EoE is the leading cause of dysphagia (difficulty swallowing) in youth and one of the main causes of phagophobia (fear of eating or choking on food). Due to lack of knowledge, the average delay in diagnosis is 2.5 in children and rises to 7 in adults. The recognized prevalence is 34.4 cases per 100,000 inhabitants, although recent data indicate that this rate has multiplied by three in the last ten years. According to specialists, EoE will soon change its current status as a rare disease.
“It is a chronic disease that, we have scientific evidence, did not exist 40 years ago,” says Alfredo Lucendo, president of Eureos (European consortium for eosinophilic diseases of the gastrointestinal tract). “In 1993, two separate researchers clearly and independently described the fundamental characteristics of this disease, which is not a variant of others, but has its own entity.” According to the doctor, head of the digestive system at the Tomelloso hospital (Ciudad Real), in the first decade few cases were recorded, but in the last “there has been an explosion, so that today it is the most frequent cause of food impaction in the esophagus in children and young adults.
It is a particular form of allergy to common foods that humans have been consuming since the Neolithic: milk, wheat, eggs and legumes. “What happened if they have been tolerated without problems for millennia and in recent years have become problematic?” asks Lucendo. The origin of the disease is unknown, and the increase in endoscopies, greater medical knowledge and greater information among society do not explain the extraordinary growth of eosinophilic esophagitis.
Although doctors attribute a genetic basis to it, they also point to the influence of environmental factors, such as changes in the way food is produced, processed, preserved and consumed (there are studies underway on how genetic manipulation can influence), and to the hygiene theory, which suggests that lower exposure to infectious agents in childhood may increase the risk of developing immunological pathologies such as EoE. “It’s not about being more dirty – not long ago, infectious diseases were the first cause of death – but we should identify the factors that specifically lead to the appearance of these diseases, assuming that we are going to live in environments more hygienic than in previous generations,” Lucendo clarifies.
While interest in researching this pathology grows, doctors, patients and relatives grouped in the Spanish EoE Association (Aedeseo) criticize the difficulties in accessing medicines in Spain. There is an effective drug for children and adolescents pending approval by price by Social Security, and in other EU and Western countries there is a medication for adults that in Spain is limited to selected patients and under restrictive conditions.
