What is Eosinophilic Esophagitis (EoE)?

Eosinophilic Esophagitis (EoE) is a chronic immune disease that affects the esophagus, leading to inflammation and difficulty swallowing. Often mistaken for acid reflux, EoE is triggered by allergens—typically foods—that cause the immune system to overreact.

 

Signs and Symptoms

Many people with EoE experience:

• Difficulty swallowing (dysphagia)
• Food getting stuck in the throat (food impaction)
• Chest pain (not related to heart disease)
• Chronic heartburn that doesn’t improve with acid-reducing medications
• Vomiting or regurgitation (especially in children)
• Feeding difficulties in infants and young children

 

Why is EoE Often Misdiagnosed?

EoE symptoms mimic acid reflux (GERD), leading to delays in diagnosis. Unlike GERD, EoE does not respond well to proton pump inhibitors (PPIs) alone, and a specialized endoscopic biopsy is needed for diagnosis.
 
 

How is EoE Diagnosed?

• Endoscopy with Biopsy: The gold standard for diagnosing EoE. At least six biopsies from different parts of the esophagus are recommended.
• EoE Endoscopic Scoring (EREFS): Helps assess disease severity during endoscopy.
• Elimination of Other Causes: Doctors rule out conditions like GERD, infections, and autoimmune diseases.

 

Best Treatment Options for EoE

1. Proton Pump Inhibitors (PPIs) – While they are no longer required for diagnosis, they remain a first-line treatment.
2. Swallowed Corticosteroids – Such as budesonide or fluticasone, help reduce inflammation in the esophagus.
3. Elimination Diets – Removing trigger foods, especially milk and wheat, can significantly improve symptoms.
4. Biologic Therapy – Dupilumab (a biologic drug) is now FDA-approved for moderate to severe EoE in patients aged 12 and older.
5. Esophageal Dilation – Used for severe cases where food frequently gets stuck due to narrowing of the esophagus.

 

Can EoE Be Cured?

Currently, there is no cure for EoE, but long-term management is essential to prevent complications such as strictures (narrowing of the esophagus). Regular follow-ups with an esophageal specialist and dietary adjustments can keep symptoms under control.
 
 

Why Choose Bumrungrad International Hospital?

At Bumrungrad Digestive Disease Center, our multidisciplinary team of gastroenterologists, allergists, and nutritionists work together to provide advanced diagnostic tools and personalized EoE treatments for both adults and children.

 

Struggling with swallowing difficulties?

Early diagnosis is key! Book an appointment with our specialists at Bumrungrad Digestive Disease Center today.
 


Tossapol Kerdsirichairat, MD, FACG, FASGE
Clinical Associate Professor of Medicine
Advanced/Bariatric Endoscopy, Digestive Disease Center
Bumrungrad International Hospital