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Your Guide to Eosinophilic Esophagitis

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Esophageal Dilation for Eosinophilic Esophagitis

Medically Reviewed By Youssef (Joe) Soliman, MD

Esophageal dilation may be a treatment option for people with eosinophilic esophagitis (EoE). This outpatient procedure can help reduce inflammation and swelling of the esophagus as part of your treatment plan for EoE.


For many people, eating can be a source of delight. However, eating can be uncomfortable and even scary for those with a rare condition called eosinophilic esophagitis (EoE). This is because EoE causes inflammation and swelling in your esophagus, the tube that connects your throat to your stomach, making it hard to swallow.

There’s currently no cure for EoE, but treatments are available, including medications and a procedure known as esophageal dilation.

Understanding eosinophilic esophagitis

EoE develops when white blood cells, such as eosinophils, accumulate in your esophagus. The eosinophils release substances that cause your esophagus to narrow and become inflamed.

Researchers think environmental and genetic factors may cause EoE. Many people with EoE may also have other allergic-type disorders, such as asthma, eczema, and food allergies.

Symptoms of EoE can include:

  • difficulty swallowing
  • food getting stuck in the esophagus, or food impaction
  • reflux
  • heartburn
  • chest pain
  • vomiting

People can sometimes mistake EoE for gastroesophageal reflux disease (GERD), a more common digestive condition.

Your doctor will need to perform an endoscopy, passing a flexible tube with a camera into your esophagus to diagnose EoE officially. They’ll look for signs of EoE and remove small tissue samples to check for eosinophils.

Treating eosinophilic esophagitis with diet and medications

If you’ve received a diagnosis of EoE, you can consider changing your diet. Your doctor may suggest an elimination diet, removing foods that typically cause allergies.

For EoE treatment, experts usually recommend the six-food elimination diet (SFED).

The SFED suggests removing common food allergens, including:

  • milk
  • wheat
  • soy
  • eggs
  • peanuts
  • fish/shellfish

You can avoid the above foods for 6–8 weeks and reintroduce them, one at a time, to keep track of inflammation.

More severe cases might require switching to an elemental diet, which consists of receiving your nutrition from a specially designed amino acid formula for several weeks.

Your doctor will likely prescribe medications to treat EoE as well. These can include:

  • Proton pump inhibitors: These drugs decrease the amount of acid in your stomach and can lower inflammation in your esophagus. They don’t work for everyone, however.
  • Steroids: Topical steroids, such as fluticasone and budesonide, are swallowable to coat the esophagus. These may decrease eosinophils and reduce esophageal inflammation.
  • Biologic medications: Dupilumab (dupixent) is an injectable medication Trusted Source Food and Drug Administration (FDA) Governmental authority Go to source that interferes with the inflammatory process. Experts are currently studying other biologics for treating EoE.

Widening the esophagus with esophageal dilation

Sometimes, dietary changes and medications may not be enough to relieve difficulty swallowing and food impaction. Scarring and narrowing of the esophagus may need treatment with esophageal dilation.

Esophageal dilation is generally an outpatient procedure. You may be under sedation and receive medication to numb your throat.

Your doctor will use an endoscope or wire to guide a balloon or plastic dilating instruments to the narrowed portion of your esophagus. They will gently expand the balloon or dilator to stretch the diameter of your esophagus.

The procedure is quick, and experts usually consider it safe. Complications are rare but can include a hole or tear in the lining of the esophagus.

Your doctor may monitor you for a short time after the dilation. You’ll receive instructions on when it’s safe to resume eating or drinking, likely returning to what’s usual by the next day. You may have a temporary sore throat.

Ongoing treatment after esophageal dilation

Esophageal dilation may provide immediate improvement of EoE symptoms. After your procedure, you can expect to feel more comfortable swallowing and eating.

However, esophageal dilation doesn’t usually eliminate the source of your EoE. Your doctor may suggest you continue to avoid certain foods. You may also need ongoing medications to lower the inflammation in your esophagus.

Notify your doctor if your symptoms return. Depending on the severity of symptoms, your doctor may consider doing a repeat esophageal dilation procedure.

Was this helpful?
  1. Eosinophilic esophagitis. (2020).
  2. Eosinophilic esophagitis. (2023).
  3. Food and Drug Administration. (2022). FDA approves first treatment for eosinophilic esophagitis, a chronic immune disorder [Press release].
  4. Lucendo AJ, et al. (2018). Esophageal dilation in eosinophilic esophagitis: Risks, benefits, and when to do it.
  5. Runge TM, et al. (2017). Control of inflammation decreases the need for subsequent esophageal dilation in patients with eosinophilic esophagitis.

Medical Reviewer: Youssef (Joe) Soliman, MD
Last Review Date: 2023 Aug 4
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