What is Eosinophilic Esophagitis?

Doctor checking child's throat

What is EOE?

Eosinophilic esophagitis (EoE) is an allergen mediated disease of the esophagus, or food pipe, that is caused by certain foods or environmental allergens. It causes inflammation of the esophagus by a specific white blood cell called the eosinophil. These eosinophils build up in the lining of the esophagus which is what causes it to get inflamed. When your esophagus is inflamed, it can cause the esophagus not to move food down to the stomach as easily. This can lead to the symptoms people experience such as difficulty swallowing or the sensation of food becoming stuck in the esophagus. It is more common in boys than girls. It is also more common in kids who have allergies, asthma, and eczema. It does run in families, so a positive family history increases your risk of developing the illness.


Symptoms are caused by the inflammation in the esophagus, but can vary depending on the age of the child. Very young kids, including infants, typically present with feeding difficulties, reflux, vomiting, or poor weight gain. Kids and teenagers present more with difficulty swallowing, heartburn, reflux, chest pain, or food getting stuck in the esophagus, also known as a food impaction.


We diagnose EoE by doing an upper endoscopy so we can directly see the esophagus and take biopsies. In order to see the eosinophils, we take small biopsies of the lining of the esophagus and look at it under a microscope. If your esophagus has an increased number of eosinophils on the biopsy, that confirms the diagnosis of EoE. To make sure you are responding to treatment, a repeat endoscopy will be performed to make sure those eosinophils are going away.


There are both dietary and medication options for the management and treatment of EoE. There are six common foods that trigger EoE and one option is to try to eliminate these foods either in a stepwise fashion or by eliminating all and slowly adding them back in. This is called the six food elimination diet (6FED) which include the following foods:
Medications for EoE include proton-pump inhibitors, swallowed steroids, antihistamines, and mast cell stabilizers. Just recently, a new medication was approved for children 12 years and older by the FDA called Dupixent (Dupilumab). This medication targets the immune system in order to prevent inflammation.


As EoE is still a relatively new disease, we are still learning how to better diagnose and treat it. Research is currently underway to develop new medications as well as new ways to identify the food triggers earlier and prevent repeat procedures. Dr. Irastorza has an interest in EoE and has recently published research on this topic.

Eosinophil-Derived Neurotoxin Predicts Response to Proton-Pump Inhibitor Treatment in Pediatric Eosinophilic Esophagitis (lww.com)
PB Digestive Pediatric Doctors

Your Pediatric Team at PB Digestive

Sari M. Kay, MD is a board-certified Pediatric Gastroenterologist. She has a specialties and expertise in treating patients with inflammatory bowel disease, celiac disease, eosinophilic esophagitis, constipation, infant reflux, and functional GI disorders.

Laura E. Irastorza, MD is a board-certified Pediatric Gastroenterologist. She has expertise in treating patients with eosinophilic esophagitis, constipation, reflux, and functional GI disorders such as irritable bowel syndrome.

 Palm Beach Digestive Associates
Palm Beach Digestive Associates

As the premier Gastroenterology Practice & Colonoscopy Clinic in South Florida, Palm Beach Digestive Associates offers the knowledge and experience valued by patients who are suffering from Digestive Problems and Liver Disease. From the most common stomach ailments to the most serious gastrointestinal issues, our Board Certified specialists are highly skilled in evaluating and treating every type of Liver and Digestive Disorder, as well as the detection and treatment of Colon Cancer.

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