Eosinophilic Esophagitis (EoE)
What it is:
Eosinophilic esophagitis (EoE) is a chronic disorder where the esophagus becomes inflamed, swollen, and
scarred due to a chronic "allergic" reaction to food, fluid, or inhaled and swallowed allergens. This can
disrupt smooth passage of food into the
EoE leads to a feeling of food sticking,
regurgitation, chest fullness or pain. When a
bite of swallowed food is bigger than the size
of the esophagus, food will become lodged and
obstruct the esophagus. If the food does not
pass, then an urgent procedure, called an
endoscopy, is required to remove the food.
Diagnostic testing requires endoscopies with
biopsy sampling of the esophagus. Endoscopy
is a sedated procedure where a flexible camera
scope is inserted into the esophagus to inspect
the esophageal lining. Esophageal biopsies are
obtained during the endoscopy. Biopsies are
required to confirm EoE.
There is no cure for EoE, just like with allergies or asthma. Longer standing EoE that is not treated can
lead to scarring and permanent narrowing of the esophagus. This leads to more problems with swallowing
and is why early treatment is needed.
Treatment for EoE:
a) The first treatment is a twice per day dose of medicine to suppress acid (PPI) to treat any reflux
disease that may be present. If the patient responds to this medicine, then ongoing treatment with
PPI is adequate.
b) Topical swallowed steroids may be needed to improve esophageal inflammation.
c) Endoscopic dilation may be needed to stretch and dilate the esophagus if medicine doesn’t resolve
d) Allergy testing may find foods to remove from diet.
e) A six food elimination diet (6-FED) is recommended. This diet gets rid of 6 common food groups
that trigger the inflammation (dairy, wheat, eggs, nuts, soy, seafood). Food groups are brought
back into the diet one at a time. Refer to Health Facts for You #553.
f) All patients need to adjust their diet. Patients should cut small pieces and chew food well before
trying to swallow. This will help food easily travel down the esophagus and into the stomach.
Problem foods such as grisly meats, dry foods, or raw vegetables and fruits should be eaten with
Follow up depends on the treatment program. In most cases, follow up will be after 2 months post-
treatment. Patients need to track their trouble with eating and drinking, changes in weight, chest pain, or
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questions. If this information was not given to you as part of your care, please check with your doctor. This is not medical advice.
This is not to be used for diagnosis or treatment of any medical condition. Because each person’s health needs are different,
you should talk with your doctor or others on your health care team when using this information. If you have an emergency,
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