What is Eosinophilic Esophagitis?
EoE is a chronic, immune-mediated condition where a type of white blood cell — the eosinophil — builds up in the lining of the esophagus. Over time this inflammation can make swallowing difficult and uncomfortable.
Common symptoms
- Difficulty swallowing (dysphagia)
- Food getting stuck (impaction)
- Chest pain or heartburn that doesn't respond to PPIs
- Regurgitation
- In children: failure to thrive, vomiting, refusing food
- Slow, deliberate eating habits or fear of certain textures
How it's diagnosed
Diagnosis requires an upper endoscopy with biopsies. A gastroenterologist looks for at least 15 eosinophils per high-power field in the esophageal tissue, while ruling out other causes of eosinophilia like reflux.
You may also be tested for food and environmental allergies, since EoE is often triggered by specific foods — most commonly dairy, wheat, egg, and soy.
The current approaches to treatment
There's no single "right" path. Most plans combine some of:
- Proton-pump inhibitors (PPIs) — first-line acid suppression that helps a meaningful subset of patients.
- Topical (swallowed) steroids — fluticasone or budesonide, designed to coat the esophagus.
- Dietary therapy — empiric elimination diets, from a single food (often dairy) up to six.
- Biologics — newer injectable therapies such as dupilumab, FDA-approved for EoE.
- Esophageal dilation — for strictures that have developed over time.
You are not alone
EoE affects roughly 1 in 700 people, and that number is rising as awareness grows. Whatever stage of the journey you're in — suspecting something is wrong, freshly diagnosed, or years into management — there's a community here for you.