Children's Hospital Colorado

Eosinophilic Esophagitis (EoE)

What is eosinophilic esophagitis?

Eosinophilic esophagitis, also known as EoE is the chronic inflammation of the esophagus caused by food allergies. Diagnosis of EoE can only be made after a biopsy, a tiny tissue sample take from the esophagus, shows increased numbers of eosinophils, a type of white blood cell associated with allergies. The inflammation can cause a number of vague symptoms including abdominal pain, reflux like symptoms, and swallowing or feeding problems.

EoE is one of several eosinophilic gastrointestinal disorders (EGID) that can affect other parts of the gastrointestinal tract:

  • Eosinophilic esophagitis affects the esophagus.
  • Eosinophilic gastritis affects the stomach.
  • Eosinophilic gastroenteritis affects the intestines or multiple areas of the GI tract.
  • Eosinophilic colitis affects the large intestine and bowel. 

What causes eosinophilic esophagitis?

EoE is called an allergen-mediated disease, meaning it is caused by exposure to certain foods in a predisposed person. The reaction happens much like when a person develops seasonal allergies after exposure to a particular allergen like pollen, dust or mold. Genetics likely contribute to the development of EoE because EoE, like other allergen mediated diseases, often affects more than one family member.

Who gets eosinophilic esophagitis?

EoE can occur in both children and adults. It usually affects boys more often than girls. EoE can run in families. For instance, it is not unusual for a parent or other relative to have a history of food getting stuck in the esophagus, swallowing problems or esophageal dilations.

Helpful resources

What are the signs and symptoms of eosinophilic esophagitis?

Patients with EoE may have a wide variety of symptoms. Very young children (infants and toddlers) may vomit or have other feeding problems. Young children may complain of abdominal pain, vomit or not want to eat. Older children may have problems swallowing or get food stuck in their throat or esophagus.

Patients with other EGIDs can have a wide variety of non-specific gastrointestinal symptoms including:

What tests are used to diagnose eosinophilic esophagitis?

While symptoms may be suggestive, an upper endoscopy and biopsy are necessary to make the diagnosis so that the eosinophils can be seen under a microscope. Patients must have other causes for inflammation, like reflux , excluded before a diagnosis of EoE can be made.

For an upper endoscopy, a gastroenterologist inserts a small lighted flexible instrument through the mouth into the esophagus, stomach and the initial part of the small intestine. The instrument has a tiny camera inside which allows the doctor to see images of your digestive system on a video screen. Pictures will be taken and small tissue samples will be obtained.

How do doctors at Children’s Hospital Colorado make a diagnosis?

It is necessary to exclude other causes for symptoms and inflammation before diagnosing someone with EoE. You doctor may recommend your child start an acid suppression medication or perform a pH test to check for acid reflux, which can cause similar symptoms, before performing an endoscopy or biopsy.

How is eosinophilic esophagitis treated?

After your child is diagnosed with EoE, his or her healthcare team will create a plan to help manage the symptoms. There is not yet a cure for EGIDs.

Your child will likely need to take medicines and/or avoid certain foods to treat EoE. It may be recommended that your child take a steroid medicine, often swallowed to coat the esophagus and to help control inflammation in the esophagus. Usually an Allergist will help to identify possible trigger foods causing the allergies. Next, you and your child will work with a dietician to identify and eliminate the specific foods that are likely allergens. Sometimes an elemental formula may be prescribed..

Why choose Children's Hospital Colorado for your child’s EoE or EGID?

Children's Colorado is a national leader in clinical care and research in eosinophilic gastrointestinal disorders. The Gastrointestinal Eosinophil Diseases Program at Children's Colorado is dedicated to providing outstanding multidisciplinary care for children with EGIDs, including EoE. Children's Colorado’s Gastrointestinal Eosinophilic Disease Program is the only program in the Rocky Mountain region to offer comprehensive care for children with EoE.

Video instructions: How to use an inhaler for EoE 


Video instructions: How to use a topical steroid for EoE

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