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Your Guide to Eosinophilic Esophagitis

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4 Signs You May Have Eosinophilic Esophagitis

Medically Reviewed By Cynthia Taylor Chavoustie, MPAS, PA-C

Eosinophilic esophagitis (EoE) is an inflammatory condition of the esophagus that can make swallowing difficult and may cause heartburn and abdominal pain. Understanding EoE symptoms can help you find a diagnosis and treatment.


EoE is a chronic condition of the esophagus. It occurs due to an allergic reaction from the immune system to foods or substances in your environment, such as dust mites, animal dander, pollen, and molds.

EoE can first appear during infancy but can develop at any point in your life. EoE symptoms vary from person to person.

Depending on your age, specific EoE symptoms may vary, and certain genes can play a role in developing EoE.

A small 2021 study Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source suggested that the occurrence of people with autoimmune disorders, such as ulcerative colitis, is higher among people with EoE than it is among people without EoE.

Common symptoms of EoE can overlap with other allergic conditions, so it’s not always obvious that EoE is the cause of symptoms. Learning more about EoE symptoms can help you talk with your doctor about the next steps.

Difficulty swallowing

For infants, this means difficulty feeding. Toddlers and older children can also have challenges eating and drinking. As a result, babies and children with EoE often refuse food and tend to experience less growth and weight gain.

The American Academy of Allergy, Asthma & Immunology notes that older children and adults with EoE may have difficulty swallowing dry or dense foods.

According to the American Partnership for Eosinophilic Disorders, EoE causes the esophagus to narrow over time. Teens and adults with EoE may get bits of food stuck in their esophagus. This can lead to choking, which can become a medical emergency.

Acid reflux

Acid reflux occurs when acid moves up from the stomach into the esophagus, causing an irritating and burning sensation commonly known as heartburn. A person who experiences frequent bouts of acid reflux may initially receive a diagnosis of gastroesophageal reflux disease (GERD).

One way doctors have tried to distinguish whether the heartburn is due to GERD or EoE is to prescribe acid suppressors, such as proton pump inhibitors (PPIs). If the medications effectively manage acid reflux, the diagnosis is likely GERD rather than EoE.

However, in recent years, researchers have suggested you can have GERD and EoE at the same time. A person may have a form of EoE called PPI-responsive esophageal eosinophilia that responds to acid suppressors. For that reason, 2019 updates on consensus diagnostic criteria Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source suggested PPI trials should no longer be one of the main tools used to diagnose GERD or EoE.

Stomach pain and nausea

In addition to abdominal pain, adults may experience chest pain separate from heartburn. Young children with EoE often experience nausea and vomiting. Adolescents and adults with EoE sometimes regurgitate food that gets stuck in the esophagus.

Sleep routine changes

Due to abdominal or chest pain, heartburn, and nausea, people with EoE may notice changes in sleeping patterns. Infants and toddlers may have difficulty falling asleep and completing a full sleep cycle. Keeping track of changes in your sleeping routine can help you and your doctor identify symptom patterns.

If you experience chest pain or heartburn when lying on your back, changing your sleeping positions may provide relief.

Next steps

For an official EoE diagnosis, your doctor can perform an endoscopy, passing a flexible tube with a camera into your esophagus. They can look for signs of EoE and remove small tissue samples to check for eosinophils.

EoE symptoms may be manageable with medications, dietary changes, or both. Working with your doctor is the best way to understand EoE symptoms, get a diagnosis, and find the right treatment.

An elimination diet can be the first step to identifying food allergies, such as dairy, nuts, eggs, fish, wheat, and soy. If you have an allergic condition, you can talk with your doctor about further testing for EoE.

Doctors may prescribe medications, including oral steroids, to relieve inflammation. If acid suppressors are effective, your doctor may recommend them as you learn about the right dietary changes.

An esophageal dilation is an outpatient procedure that can help reduce inflammation and swelling of the esophagus in severe cases of EoE.

You can track your symptoms and contact your doctor because EoE symptoms don’t always point to EoE as their cause.

Was this helpful?
  1. Ayaki M, et al. (2021). Prevalence of autoimmune disease in patients with eosinophilic esophagitis: A cross-sectional study of three hospitals in Japan.
  2. Dellon ES, et al. (2018). Updated international consensus diagnostic criteria for eosinophilic esophagitis: Proceedings of the AGREE conference.
  3. EOE. (n.d.).
  4. Eosinophilic esophagitis. (2023).

Medical Reviewer: Cynthia Taylor Chavoustie, MPAS, PA-C
Last Review Date: 2023 Sep 29
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