Key Points about Eosinophilic Esophagitis (EoE)

  • Experts believe that EoE is caused by the body’s overreaction to certain food allergy triggers.
  • Specialists use upper endoscopy with biopsy to confirm a diagnosis of EoE.
  • Treatment for EoE typically includes diet modifications, medications and, in some cases, surgical opening up of the narrowed esophagus.
Common related conditions
Barrett's Esophagus

Overview

Eosinophilic esophagitis – or EoE – is a rare, chronic (long lasting) condition that affects the esophagus. The esophagus is the tube that connects the mouth to the stomach. EoE develops with a certain type of white blood cell – called the eosinophil – that accumulates in the esophagus. The excess eosinophils injure the esophagus and lead to inflammation (swelling).

Eosinophilic esophagitis causes 

Experts don’t yet know the exact cause of this condition. Many believe that an immune response to certain foods may cause EoE. Many people with EoE also have food or environmental allergies. 

Eosinophilic esophagitis risk factors

The following factors may increase your risk for developing EoE:

  • Being male
  • Having asthma
  • Having eczema
  • Having family members with EoE
  • Having rhinitis

Eosinophilic esophagitis symptoms

Symptoms of this condition can vary, but may include:

  • Acid reflux that can’t be controlled with medication
  • Failure to thrive (in babies and children)
  • Food getting stuck in the esophagus
  • Low appetite or refusing to eat
  • Nausea and vomiting
  • Pain in the abdomen or chest
  • Trouble sleeping due to pain, reflux or nausea
  • Trouble swallowing

Eosinophilic esophagitis diagnosis

Your gastroenterologist may use one or more of the following diagnostic tools to diagnose your EoE:

Physical examination. Your doctor will ask questions about your general and digestive health history. Many of the symptoms of EoE are similar to gastrointestinal reflux disorder (GERD). It’s important for your doctor to rule out that condition.

Upper endoscopy. This is a painless test that our team typically conducts on an outpatient basis. For this test, you will be sedated (asleep). Your specialist will insert a small tube (endoscopy) through your mouth. Your specialist uses the tube to closely examine your esophagus, stomach and first part of the small intestine. Your specialist may also take biopsies (small tissue samples) for closer analysis in the lab.

Eosinophilic esophagitis treatment

Most people with EoE need a combination of the following treatments to effectively manage the condition:

Diet modifications. Your specialist may recommend that you avoid certain foods to which you may be allergic, such as milk, wheat, eggs, soy, peanuts/tree nuts or fish/shellfish. In extreme cases of the condition – or if you are malnourished – your specialist may prescribe a feeding tube diet to ensure you are receiving proper nutrition.

Medications. Certain medicines can help suppress your body’s overactive response to food triggers. This will reduce the symptoms of EoE. Your specialist may prescribe topical steroids or acid suppressors.

Surgical dilation. If your esophagus has narrowed due to EoE, your specialist may recommend surgical dilation (opening up) to correct it. In this procedure, your specialist inserts a tube or inflates a balloon within your esophagus to help stretch it back to a more normal width.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing a gastroenterologist for more specialized treatment.