Cobblestone Oesophagus

Not so much an related condition but an associated possible symptom, Cobblestone Oesophagus is a term used to describe the appearance of the oesophageal lining resembling cobblestones with lumps and bumps.

Images from Cureus of views in ordinary and differentiated coloured light.

It is a rarely observed phenomenon usually associated with Eosinophilic oesophagitis (EoE) as in this 2021 reported incidence, "Cobblestone esophagus in eosinophilic esophagitis". but it is still not fully understood.

As detailed in this 2017 report, "Cobblestone Appearance of Esophagus: An Unusual Symptom of Pyloric Stenosis", it may also result from obstruction in the lower GI tract which can exacerbate acid reflux.

This 2024 incidence found "An Unusual Presentation of Cobblestone Esophagus From Bisphosphonate Use". Bisphosphonats like Alendronic Acid are typically used in the treatment of osteoporosis and can result in oesophagitis.

Symptoms may include difficulty swallowing, chest pain, and heartburn.

Treatment will require identification of cause where possible and treatment relevant to that, like acid suppressants and lifestyle modifications or may involve dietary changes as for EoE, such as elimination diets. 

Page updated 21 January 2024