Eosinophilic esophagitis (EoE) (pronounced as e-o-sin-o-FILL-ik uh-sof-uh-JIE-tis), is a swallowing disorder that affects the esophagus, the tube that leads from the throat to the stomach. EoE is an allergic response that happens when eosinophils (a type of white blood cell) collect in the esophagus. Food can be a trigger, as can pollen.
Symptoms in children include vomiting, weight loss, or “failing to thrive” (in an infant). Reflux, difficulty swallowing, and chest pain are other symptoms – especially in adults and older children. The condition is difficult to understand as symptoms can change, go away, come back, and even occur hours, days, or weeks after eating an allergen.
EoE is often diagnosed after a long process that eventually leads a person to the allergist. The only way to diagnose EoE is through an upper endoscopy, where a camera is inserted down the esophagus and biopsies are taken. Skin tests for food (or pollen) allergens are usually conducted. Like other food allergies, there are some more common allergens, but it can be caused by any food.In addition to avoiding the allergenic food, other dietary, medication, and experimental treatments are used to treat EoE.
What is a NG?
NG is the short way of saying nasogastric tube. Naso means nose and gastric means stomach. So a NG goes into your nose and down into your stomach. The NG is actually a long, very bendy flexible tube. It will be taped to your nose and cheek.
Why do I need to have a NG?
Sometimes you will have a NG if you have to take special medicine that you are having a difficult time drinking by mouth. Other times, you may have a NG to help you get the food and nutrients that you body needs, especially if you are not eating or are unable to eat. A NG tube may also be used to drain extra fluid or air from your stomach.
What does a NG look like?
The NG is a long, very bendy flexible tube. It may be attached to a bag that hangs from a pole. The pole is the same pole used to hang an IV (intravenous) bag. The bag contains food or medicine depending on what you need. There may be a small computer attached to the NG, the computer controls how fast or slow the medicine or food moves into your stomach. The computer will beep when the medicine or food is almost done, or if the battery is low, it beeps even if there is a bend in the plastic tube. The beep tells the nurses to come and check your NG. If the NG is being used for draining fluid from your stomach, then it may be connected to a machine on the wall that will help remove the extra stomach fluid. If this is the type of NG you have, you may hear a noise like a gurgling sound when the NG is working.
What happens when I have a NG?
A nurse will come to you to insert the NG. He/she will measure the length the NG has to be by measuring from the tip of your nose to your ear, and then down to your stomach area. The nurse marks the tube to know how far it has to go in to reach your stomach.
The tip of the NG will be covered in a clear jelly, this helps to make it slippery. The nurse will then start sliding it into your nose, and move it gently down your throat and into your stomach. The nurse may ask you to drink water and swallow as it is happening, this can help it to go down easier.
Once it is in place the nurse will check to make sure that it is in the right place. Also, the nurse will use a small strip of paper to check to make sure that the fluid from the tube is stomach fluid. The paper will change colour with the fluid that lets the nurse know that it is stomach fluid, which means that the tube is in the right spot.
Once it is in the right place, the nurse will use soft tape to hold the NG tube in place. The tape will be on your cheek and maybe on your nose.
What will the NG feel like?
? It will feel uncomfortable when it is going into your nose.
? You may feel like you have to throw up or gag when it is going in.
? You may feel like you have something stuck in your throat after the tube is in for the first little while until you get used to the tube being there.
Preparing for the test
There is nothing that you need to do to prepare a NG. You do not have to go anywhere to have the test done; your nurse will come into your room to do it.
If you have any questions about the test, always ask! You can have your parents and/or child life specialist with you during the procedure to help you.
What is a Barium (Contrast) Swallow?
A barium swallow is a test that uses a special drink that looks like white milk or a clear drink (like water) called barium or contrast as well as an X-Ray. Sometimes it is also called an Upper GI (upper gastrointestinal test) because the upper GI includes your esophagus and stomach. The barium (contrast) drink is used to help the doctor see better or highlight the areas that the doctor wants to look at, usually your esophagus and stomach. The X-Ray is used to take the pictures.
Why do I need to have a Barium Swallow?
You may have to have a barium swallow if the doctor wants to check to see how your esophagus and stomach are working and what they can do to help you.
What does a Barium Swallow look like?
The barium swallow is done where X-Rays are taken (radiology department). The drink is white or clear; if it is white, it looks like a milkshake, if it is clear it looks like water. There is also a bed with the X-Ray machine. Along with the X-Ray machine there is a computer and TV screen. The TV shows the pictures taken by the X-Ray of your esophagus and stomach.
What happens when I have a Barium Swallow?
If you are already in the hospital, a porter will come to bring you to the special room to have the barium swallow. A technologist (the person who will take the pictures) will greet you and explain what will happen.
The technologist will give you a gown to wear, this looks like a backward housecoat, you may already be wearing one.
You will be asked get up on a bed. The technologist will then bring out the barium drink and tell you when to start drinking. You may be asked to take a few gulps and then wait a bit. After you have swallowed some or most of the contrast, the doctor or the technologist will take some pictures using the X-Ray. As you drink, the contrast moves down your esophagus and into your stomach (this is called the digestive tract). The contrast makes it really easy for the X-Ray to see inside your body and take clear pictures. You may be able to see your esophagus and stomach on the TV screen. They may continue to ask you to take a few more sips of the drink as they continue to take the X-Rays. They may also move the bed you are on to help the contrast move around. The bed may tilt forward and back, but do not worry, if this happens you will be safe so that you do not move on the bed.
If the doctor wants pictures of your small bowels, you will have to wait a little longer until the contrast reaches that part of you body. To reach the small bowels the contrast first has to go through the esophagus, then to the stomach and then finally reaching the small bowel. When the barium reaches the small bowels, the technologist will then take more pictures. Some children may need to take a special medicine that helps them poop before they take the test. Sometimes, the technologist will gently place a small tube in your rectum (bum); the doctor or technologist will put a puff of air through the tube. This may feel a bit uncomfortable or it may make you feel like you need to go to the bathroom.
Someone like your mom or dad can stay in the room with you during the test. When it is over, you are able to go back to your room or go home.
What will the Barium Swallow feel like?
The barium swallow will not hurt. You cannot see, feel or hear the X-Rays. The contrast drink that you have to swallow can be thick and white like a milkshake but it does not taste like a milk shake; or it can be clear like water. The contrast drink can taste like a banana that is not ripe, giving you a chalky taste in your mouth. Some people like this taste and others do not. Sometimes when the technologist needs to see your bowels better, they may need to place a small tube in your rectum (bum) which may feel a little uncomfortable and it may feel like you have to go to the bathroom.
Remember to lie still so they can get a clear picture of your digestive tract. After you are done, you may notice that when you go to the bathroom your stool (poop) may be white. That is just because the barium was white and thick.
Preparing for the test
Your nurse will give you the information you need to help you get ready to have your barium swallow. She will tell you what you can and cannot eat or drink before the test.
If you have any questions about the test, always ask!