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Eosinophilic Esophagitis (EoE)

What is eosinophilic esophagitis (EoE)?

Eosinophilic esophagitis (EoE) causes inflammation in the esophagus. The inflammation is caused by immune cells called eosinophils. They are not normally present in the esophagus. It affects about 0.05% of the population with a male predominance (M:F 3:1). It can happen in both children and adults, and sometimes run in the family.

What are the symptoms?

In children, feed dysfunction, vomiting, abdominal pain, swallowing difficulty and food getting stuck in the esophagus are common symptoms. In adults, difficulty swallowing solid foods and food impaction are the most common symptoms. Chest pain refractory to antacids, heartburn, upper abdominal pain, and cough are other symptoms associated with EoE.  

Is EoE caused by food allergy?

Yes.  Approximately 70% of patients respond well to dietary manipulations. The food allergy that is associated with EoE is quite different from the "classic" food allergy. Unlike "classic" food allergy, ingestion of food(s) causing EoE only affects the esophagus and does not cause the typical allergic reactions such as hives, swelling, wheezing or anaphylaxis.  Skin prick testing, patch testing and blood tests may be helpful in identifying the food trigger(s) in some cases. 

How is EoE diagnosed?

There are no specific blood tests that can confidently make the diagnosis of EoE. In patients suspected of having EoE, the first diagnostic test is typically an upper endoscopy with esophageal biopsies.

How is EoE treated?

The management of EoE includes pharmacologic, endoscopic and dietary therapy. The goal is to relieve symptoms and to get rid of the inflammation in the esophagus. Therapy must be individualized depending on clinical symptoms, endoscopic findings, histological assessment and personal preference.

 Evaluation and treatment at Tufts Medical Center

If you think you or your child might have EoE and would like to be evaluated, please call the Food Allergy Center at Tufts Medical Center and Floating Hospital for Children at 617-636-5333 (for adults) or 617-636-3266 (pediatrics).  Our expert team will provide an evaluation and treatment plan, should you need it.