Patient education: Eosinophilic esophagitis (The Basics)

What is eosinophilic esophagitis? — Eosinophilic esophagitis, or "EoE," is a condition that affects the esophagus. The esophagus is the tube that carries food from the mouth to the stomach (figure 1). In EoE, the esophagus has cells called "eosinophils" in it. Eosinophils are allergy cells that are not normally found in the esophagus.

Doctors don't know for sure what causes EoE. But they think that it might be caused by allergies, especially food allergies.

EoE sometimes runs in families. It can happen in both children and adults.

What are the symptoms of EoE? — Symptoms can be different, depending on the person's age.

Adults and teens usually have symptoms such as:

●Trouble swallowing – This is the most common symptom. People usually have trouble swallowing solid foods. Some people have pain with swallowing or feel like the food gets stuck in their throat or chest.

●Chest or upper belly pain

●Burning in the chest (heartburn) that doesn't get better after taking medicine to treat heartburn

Children usually have symptoms such as:

●Feeding problems, such as refusing to eat solid foods

●Nausea or vomiting

●Belly pain

Is there a test for EoE? — Yes. The test done most often to check for this condition is an upper endoscopy.

During an upper endoscopy, a doctor puts a thin tube with a camera and light on the end into your mouth and down into your esophagus (figure 2). They will look at the lining of the esophagus and take small samples of it. Another doctor will then look at the cells under a microscope to see if you have EoE.

How is EoE treated? — Treatment usually involves diet changes and medicines:

●Diet changes – Your doctor might have you avoid foods that could be causing your symptoms. There are 3 main ways to do this. You can:

•Avoid the foods that most commonly cause EoE – Most people choose this approach. Doctors often suggest starting by avoiding milk and dairy products.

•Avoid the foods that you are allergic to – To figure out the foods that you are allergic to, you might need to get tests. This usually involves going to an allergist (allergy doctor).

•Go on a special liquid diet – This means avoiding all solid foods.

To make sure you get the nutrition you need, your doctor might recommend that you work with a dietitian (food expert). After your symptoms improve, you will be able to add foods back into your diet.

●Medicines – Doctors can use different medicines to treat EoE. One is called a "proton pump inhibitor." This medicine is usually used to treat acid reflux, which is when acid that is normally in the stomach backs up into the esophagus. People with EoE sometimes have acid reflux, but this medicine can treat EoE, too.

Other medicines include steroids, which help reduce inflammation. Steroids might be taken by mouth as a solution or pill. Or they can be used with a device called an inhaler. For the inhaler, you don't breathe in the steroids the way you normally would with inhaler medicines. Instead, you allow the medicine to build up in your mouth and then you swallow it.

If these treatments do not help, doctors might try another type of medicine.

In some people, EoE leads to a condition called an "esophageal stricture." This is a narrowing of the esophagus. The main treatment in people who do not improve with medicines is a procedure to widen the esophagus, called "dilation." This is done during endoscopy.

More on this topic

Patient education: Esophagitis (The Basics)
Patient education: Dysphagia (The Basics)
Patient education: Upper endoscopy (The Basics)
Patient education: Food allergy (The Basics)
Patient education: Esophageal stricture (The Basics)
Patient education: Acid reflux and GERD in children and teens (The Basics)
Patient education: Acid reflux and GERD in adults (The Basics)
Patient education: Eosinophil count (The Basics)
Patient education: Thickening liquids (The Basics)

Patient education: Food allergy symptoms and diagnosis (Beyond the Basics)
Patient education: Gastroesophageal reflux disease in children and adolescents (Beyond the Basics)
Patient education: Gastroesophageal reflux disease in adults (Beyond the Basics)