What is eosinophilic esophagitis (EoE)?
Eosinophilic esophagitis (EoE) is a chronic inflammatory condition that affects the esophagus, the tube that carries food from the mouth to the stomach.

In EoE, a type of white blood cell called an eosinophil builds up in the lining of the esophagus, usually as a reaction to certain foods or environmental allergens. Over time, this inflammation can make swallowing difficult and may lead to scarring or narrowing of the esophagus if left untreated.

Although there is currently no cure for EoE, effective treatments can help control symptoms and reduce inflammation.

What causes eosinophilic esophagitis?
EoE is thought to be caused by an immune system reaction to certain foods or environmental allergens. Many people with EoE also have other allergic conditions, such as:

  • Asthma
  • Eczema
  • Seasonal allergies (hay fever)
  • Food allergies

EoE can occur at any age but is most commonly diagnosed in children and young to middle-aged adults.

Symptoms of eosinophilic esophagitis
Symptoms vary by age and may develop gradually over time.

Common symptoms include:

  • Difficulty swallowing
  • Food getting stuck in the esophagus (food impaction)
  • Chest pain
  • Heartburn
  • Upper abdominal discomfort

In infants and young children, symptoms may also include:

  • Abdominal pain
  • Vomiting
  • Poor appetite
  • Feeding difficulties
  • Poor growth or inadequate weight gain

Diagnosing eosinophilic esophagitis
The only way to diagnose EoE is with an upper endoscopy (EGD) and biopsies of the esophagus.

During the procedure, your provider examines the esophagus using a thin, flexible tube with a camera and takes small tissue samples. These biopsies are examined under a microscope to look for an increased number of eosinophils.

Some people with EoE have a normal-appearing esophagus during endoscopy, while others may have rings, furrows, white plaques, or narrowing of the esophagus.

Treatment for eosinophilic esophagitis
Treatment focuses on reducing inflammation, relieving symptoms, and preventing long-term damage to the esophagus.

Treatment options may include:

  • Dietary changes
  • Medications
  • Esophageal dilation in selected patients with narrowing

Dietary management
Because certain foods often trigger EoE, dietary therapy can be an effective treatment.

Common food triggers include:

  • Dairy
  • Wheat
  • Eggs
  • Soy
  • Peanuts and tree nuts
  • Fish and shellfish

Your provider may recommend an elimination diet and refer you to a registered dietitian to help identify food triggers while maintaining balanced nutrition.

Complications of eosinophilic esophagitis
Without treatment, ongoing inflammation can lead to:

  • Narrowing of the esophagus (stricture)
  • Food impaction
  • Scarring of the esophagus

Rarely, severe inflammation can cause a tear in the esophagus.

When to seek care
Talk with your healthcare provider if you experience:

  • Difficulty swallowing
  • Food getting stuck while eating
  • Persistent heartburn
  • Chest discomfort
  • Symptoms that continue despite treatment

Seek emergency medical care if food becomes lodged in your esophagus and you are unable to swallow or breathe.

Contact us
If you have questions about eosinophilic esophagitis or treatment options, please contact our office at 612-871-1145.