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Updated: Mar 31, 2026
Author Spotlight: Investigating the Pathophysiology of Eosinophilic Esophagitis
Published on: May 10, 2024
Diagnosis and management of eosinophilic esophagitis in children
Insights
Eosinophilic esophagitis (EoE) is an immune-related esophageal inflammation increasingly seen in children with allergies. Diagnosis involves endoscopy with biopsies, and management requires collaboration between specialists using medical or dietary treatments.
Area of Science:
- Gastroenterology
- Immunology
- Pediatrics
Background:
- Eosinophilic esophagitis (EoE) is an immune-mediated esophageal inflammatory condition.
- Its prevalence and incidence are rising, particularly in Canada.
- EoE often co-occurs with other allergic conditions in children.
Purpose of the Study:
- To define eosinophilic esophagitis (EoE).
- To outline diagnostic methods for EoE.
- To describe management strategies for EoE.
Main Methods:
- Diagnosis involves upper endoscopy with esophageal biopsies.
- Proton pump inhibitor (PPI) therapy is typically administered during the diagnostic process.
- Clinical presentation, including dysphagia and feeding difficulties, guides suspicion.
Main Results:
- EoE is characterized by esophageal inflammation due to immune system activity.
- Symptoms like solid-food dysphagia, vomiting, and feeding issues, especially in boys with atopy, suggest EoE.
- Biopsies confirm the presence of eosinophilic infiltration.
Conclusions:
- EoE diagnosis requires a biopsy-confirmed eosinophilic presence in the esophagus.
- Management necessitates a multidisciplinary approach involving gastroenterology and allergy specialists.
- Treatment options include pharmacotherapy and dietary interventions.
Question:
After a few years of difficulty swallowing solids and feeling like food was getting stuck, a 13-year-old boy in my practice with peanut allergy and asthma was recently diagnosed with eosinophilic esophagitis (EoE). What is EoE and how is it diagnosed and managed?
Answer:
Eosinophilic esophagitis is an immune-mediated disease resulting in inflammation of the esophagus. It is increasing in prevalence and incidence in countries like Canada, and frequently occurs in children with other allergic conditions. Unexplained feeding difficulties, vomiting, and solid-food dysphagia, especially in boys with atopy, supports the possibility of having EoE. A formal diagnosis is obtained by reviewing esophageal biopsies obtained through upper endoscopy performed while the patient is taking a proton pump inhibitor. Once EoE has been established, management should involve working collaboratively with gastroenterology and allergy specialists. Medical or dietary treatments are acceptable therapeutic approaches.
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