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Diagnosis & Treatment

Eosinophilic Esophagitis

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How is Eosinophilic Esophagitis (EOE) Diagnosed?

Diagnosis

If your doctor suspects you might have the condition, you may have the following exams and tests to diagnose eosinophilic esophagitis:

  • Physical exam and medical history. Your doctor will examine you and also speak with you about your symptoms and what triggers them.
  • Endoscopy. A gastroenterologist performs this test, which involves examining the inside of your esophagus using a flexible scope with a camera at its tip to see if there is inflammation. You will receive medication so you will be asleep and comfortable during this procedure.
  • Biopsy. During endoscopy, your doctor will take a small sample of tissue from your esophagus to be analyzed. A high number of eosinophils in your esophageal tissue is a sign that you may have EOE.

How is EOE Treated?

Treatment

Eosinophilic esophagitis is a lifelong disease whose symptoms can come and go. It is helpful to learn the triggers of your symptoms so you can avoid them.

Your healthcare team of gastroenterologists, allergists, and registered dietitians will evaluate your symptoms, customize your eosinophilic esophagitis treatment, and recommend dietary changes to improve your comfort.

Dietary changes

Identifying and avoiding the foods that cause inflammation in your esophagus can be an effective way to treat EOE. Your team will work with you to identify which foods may be causing your EOE symptoms so you can eliminate them from your diet. Your nutritionist will help design a personalized diet that enables you to enjoy food and eat a well-balanced diet.

Diets that have been shown to be beneficial for people with EOE include:

  • Food trial. You remove specific select foods from your diet and then potentially adding them back one at a time to see which ones provoke your symptoms and cause inflammation to be seen on biopsies.
  • Six-food elimination diet. Instead of eliminating select food groups, you avoid all of the common inflammation-causing foods: dairy products, wheat, eggs, soy, tree nuts, and fish/shellfish.
  • Elemental diet. All protein sources are eliminated from your diet and you drink an amino acid formula instead.
Medications

Many people with EOE achieve relief by taking medications such as:

  • Topical steroids through the mouth as a liquid or via an inhaler to reduce inflammation in the esophagus, such as fluticasone or budesonide
  • Drugs that reduce acid production in the stomach called proton pump inhibitors (PPIs), such as omeprazole or esomeprazole
  • Dupilumab, a "biologic" medication given as an injection that helps stop inflammation by targeting certain allergy-related factors
Esophageal dilation

Some people who develop scar tissue in the esophagus and may need to have the esophagus dilated (stretched) to open any narrowing and ease the passage of food. This procedure can be done during endoscopy.

FAQs

FAQs

It can be but there is more data to show that there are environmental factors behind EOE.

EOE is considered to be a rare disorder. It affects about 1 in every 2,000 people.

The most effective therapies to reduce or prevent symptoms include dietary changes, medications, and when needed, dilation of the esophagus if it becomes constricted.

Get Care

Trust NewYork-Presbyterian for Eosinophilic Esophagitis Treatment

NewYork-Presbyterian has advanced specialists with decades of experience treating eosinophilic esophagitis. We can offer you the most up-to-date information and approaches, including opportunities to participate clinical trials when appropriate.

If you have symptoms of EOE, it is important that you see a doctor for effective care to reduce your risk of complications. Contact us today to make an appointment for a consultation.