You Might Also Like: Eating, Interrupted

Ali (0:06)

She was sick, she felt fragile, you know, she's this tiny little human, she's one years old, and she can't eat comfortably. It just felt deflating is maybe the best way I could describe it.

Cynthia McFadden (0:21)

This is Eating, Interrupted. We dig into the real stories in science behind how the simple acts of swallowing food can impact you from the very first bite to the complex journey that follows. I'm your host, Cynthia McFadden. This episode is brought to you by Sanofi and Regeneron. Dupixent, Dupilubab is a prescription medicine used to treat adults and children one year of age and older with Eosinophilic esophagitis, EoE, who weigh at least 33 pounds or 15 kilograms. It is not known if Dupixent is safe and effective in children with EoE under one year of age or who weigh less than 33 pounds, 15 kilograms. Do not use if you're allergic to Dupilubab or to any of the ingredients in Dupixent. Please stay tuned for full Dupixent important safety information and go to full prescribing information including patient information at bit.ly slash Dupixent PI or visit dupixent.com/eoe.

Hi, everyone. Welcome back to another episode of Eating, Interrupted. If you tuned in before, you'll know we learned all about EoE, what it is, how it can affect meal times, and just how important it is to find the appropriate care and treatment options so meal time doesn't have to be a source of uncertainty. And for this episode, we're continuing our deep dive into this condition by focusing on a topic that's incredibly important for so many families, raising kids with EoE. Because when it comes to children, the challenges can look a little different, and sometimes they can be even harder to recognize. Today I'm joined by two guests who bring both personal and clinical perspectives to this conversation. But before we get started, just one quick note. Our guest physician today is a paid partner of Regeneron and Sanofi. And our main guest is a paid caregiver ambassador, also with Regeneron and Sanofi. All right, let's dive in.

First up, I'm joined by Dr. Josh Wechsler of Northwestern University's Feinberg School of Medicine. He's a recognized leader in the care and research of eosinophilic gastrointestinal disorders, including pediatric EoE.

Well, let me start by saying thanks for joining us on the podcast today, Dr. Wechsler. Great to talk to you.

Josh Wechsler (3:01)

Yeah, truly an honor to be here and get to discuss this with you.

Cynthia McFadden (3:05)

So tell us a little bit about the work you do with EoE with pediatric patients.

Josh Wechsler (3:10)

Yeah. So I'm a pediatric gastroenterologist. I take care of kids of all ages, from age one, you know, even young adults, as old as in their early 20s. And that's because eosinophilic esophagitis really impacts all ages.

And I'm truly passionate about what I do. And having the ability to work with kids and really have a deep understanding of this disease, how it impacts them and how it can really help them, it's just so motivating for me. And I really, really love what I do.

Cynthia McFadden (3:39)

So how does EoE present differently in children as young as a year old versus adults? And how do those early symptoms vary in the early ages?

Josh Wechsler (3:50)

Yeah, and this can get very confusing, but with toddlers, it's oftentimes very nonspecific. You can have things like refusing to eat, you can have irritability, choking, or even just vomiting. And it's not always vomiting every single day, it can be vomiting maybe every few days or even a couple times a month. You can have poor growth. Maybe the major thing is, is the parent notices the kids really just not gaining weight or even maintaining their weight. When it comes to school age children, a lot of times that vomiting and gagging now starts to show up where maybe it's a little bit more obvious, but you also see symptoms like reflux or sometimes they just say their stomach hurts, and that may be actually some of the heartburn they're having. With adolescents, it tends to be more adult like symptoms. So things like difficulty swallowing, feeling like the food's going down slowly, feeling like it gets stuck, or even just sometimes a non-typical presentation, more of that heartburn acid reflux type thing.

One of the challenges is that EoE symptoms can look like other conditions such as food allergies or GERD. This makes diagnosis challenging and can lead to treatment delays.

Cynthia McFadden (4:57)

So why is EoE sometimes missed in children?

Josh Wechsler (5:03)

I think picky eating is the easiest one for me to really hone in on, and where pickiness has a clear pattern, let's say that it's focused on specific textures, chewier textures or drier textures like rice or breads, and really these are the foods that the patients averse to, that's a sign that they may actually be having trouble getting that food down. That's because the esophagus, it's a muscle that propels the food down to the stomach, and it's going to have more challenges with those specific textures. So that's one of the big ones, and that really dovetails nicely with those feeding preferences. So when you see specific feeding behaviors, it can be very confusing.