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Your Guide to Eosinophilic Esophagitis

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Signs Your Child May Have Eosinophilic Esophagitis

Medically Reviewed By Karen Gill, M.D.

Recognizing the signs of eosinophilic esophagitis (EoE) can help you monitor your child for symptoms, find the right diagnosis, and learn about treatment options to prevent complications.


EoE is a chronic inflammatory condition that affects the digestive system. If your child has an allergic condition such as food allergies, eczema, or asthma, they may have a higher risk of developing EoE.

The National Organization for Rare Disorders (NORD) suggests that EoE affects about 1 in 2,000 people.

Getting treatment for EoE can prevent esophageal scarring from the condition, which can narrow the esophagus. Treatment can also prevent food from getting stuck or impacted in the esophagus, which may lead to complications.

Symptoms of eosinophilic esophagitis

Understanding EoE symptoms can help you and your child feel confident about finding a diagnosis and treatment.

Common EoE symptoms can include the following:

  • difficulty swallowing
  • food impaction
  • chest pain
  • refusal to eat
  • an increased sensitivity to food textures

EoE symptoms in young children are often similar to gastroesophageal reflux disease (GERD) symptoms and may overlap. Both can cause esophagus scarring, which can be painful and make eating and swallowing difficult.  

A key sign is weight loss or difficulty gaining weight. If your child has either EoE or GERD, they may not gain weight, grow, or both. It may be common for children with EoE to spit up or vomit frequently. Since the diseases have different causes and treatments, you can consider talking with their doctor about recent symptoms.

Symptoms vary by age

One thing to keep in mind if you notice any changes in your child’s behavior, appetite, or weight is that EoE symptoms can and often vary by age.

For example, a baby or toddler might turn their head away from food and refuse to eat. They might not gain weight as expected, either.

Meanwhile, a slightly older or school aged child with EoE might complain of stomach aches or frequent abdominal pain. They may claim they’re not hungry, vomit when they eat, or have difficulty swallowing.

According to the American Academy of Allergy, Asthma & Immunology, teenagers and adults can experience all those symptoms. Additionally, they’re more likely to have difficulty swallowing — dry, dense, or solid foods — due to an inflamed esophagus.

What to expect from the diagnosis process

A diagnosis is the first step to understanding symptoms and finding the right treatment options. You can consider talking with your child’s primary doctor for an evaluation. They can perform a physical exam, discuss medical history, and work with you and your child to create a treatment plan.

The doctor may refer you to a pediatric gastroenterologist to address EoE symptoms. The gastroenterologist can perform an upper endoscopy if they want to confirm an EoE diagnosis. This procedure helps doctors examine the esophagus, stomach, and the upper part of the small intestine.

During the upper endoscopy, the doctor may take small tissue samples to examine later for eosinophils, the white blood cells that cause the inflammation. If they can rule out other conditions and find many eosinophils — at least 15 eosinophils — they can confirm an EoE diagnosis.

Next steps

If your child receives an EoE diagnosis, their doctor can suggest a treatment plan to manage symptoms. You can also work with a registered dietitian to try an elimination diet and identify potential food triggers. Managing EoE symptoms is possible, and medication is available to help people avoid complications.

If you want to understand more about EoE or think your child may be experiencing EoE symptoms, talk with their doctor and ask for ways to help your child navigate this process.

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Medical Reviewer: Karen Gill, M.D.
Last Review Date: 2023 Sep 29
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