What is eosinophilic esophagitis?

Eosinophilic esophagitis (EoE) is a long-term condition that causes inflammation in the esophagus, the tube that carries food from the mouth to the stomach. The condition happens when the immune system reacts to certain foods or allergens, leading to a buildup of white blood cells called eosinophils in the esophagus.

Over time, this inflammation can make the esophagus swollen, stiff, or narrow. This may make swallowing uncomfortable or cause food to become stuck. EoE is commonly linked to allergic conditions. Certain foods, seasonal allergens, or environmental triggers may cause the immune system to react.

Risk factors may include:

• Asthma
• Eczema
• Food allergies
• Seasonal allergies
• Family history of EoE

Symptoms

Symptoms of EoE can vary from person to person and may develop slowly over time.

Common symptoms include:

• Trouble swallowing
• Food getting stuck in the throat or chest
• Heartburn or chest discomfort
• Abdominal pain
• Nausea or vomiting
• Feeding difficulties in children
• Poor growth or weight gain in children

How is it diagnosed?

A healthcare provider will review your symptoms, medical history, and any history of allergies. Many people are referred to a gastroenterologist for further evaluation.

Diagnosis usually includes an upper endoscopy, which allows the provider to look inside the esophagus using a thin flexible tube with a camera. Small tissue samples, called biopsies, are taken during the procedure to check for eosinophils and signs of inflammation.

Some patients may also benefit from allergy testing to help identify possible triggers.

How is it treated?

Treatment for EoE focuses on reducing inflammation, easing symptoms, and preventing damage to the esophagus.

Many people improve with conservative treatments such as:

• Avoiding trigger foods
• Following an elimination diet
• Taking acid-reducing medications called proton pump inhibitors (PPIs)
• Using swallowed corticosteroid medications to decrease inflammation

If the esophagus becomes narrowed, a provider may recommend esophageal dilation to gently stretch the area and improve swallowing.

Because EoE is a chronic condition, ongoing care is important. Regular follow-up visits can help monitor symptoms and reduce the risk of long-term complications such as scarring or strictures.