Which condition is a chronic immune-mediated disease with eosinophil buildup in the esophagus due to certain foods?

• A. GERD
• B. Halitosis
• C. Eosinophilic esophagitis
• D. Pyrosis

Answer: (C)

This is a chronic immune-mediated disease of the esophagus characterized by eosinophil infiltration driven by food antigens. In eosinophilic esophagitis, eosinophils accumulate in the esophageal lining as part of an allergic-type response to certain foods, leading to symptoms like difficulty swallowing, food getting stuck, and chest pain, especially in adults, with possible feeding problems in children. The connection to foods comes from an immune reaction to dietary proteins, so removing triggering foods or using swallowed topical steroids can improve symptoms. Diagnosis is confirmed by endoscopy with biopsy showing a high number of eosinophils in the esophageal epithelium (often defined as around 15 or more eosinophils per high-power field). This differs from GERD, which is acid reflux without the eosinophilic esophageal inflammation that defines eosinophilic esophagitis; the other options describe symptoms (halitosis, heartburn) rather than the underlying immune-driven esophageal condition.