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May 22, 2026 is World Eosinophilic Esophagitis (EoE) Day.
More than 470,000 people in the United States live with eosinophilic esophagitis (EoE), a condition that was once considered rare but has become increasingly common over the past two decades.
Knowing what EoE is can help you figure out whether it might affect you.
What is Eosinophilic Esophagitis? (EoE)?
EoE is a chronic (long-term) immune disorder that affects the esophagus, the tube that connects your mouth to your stomach. EoE occurs when a type of white blood cell called eosinophils builds up in the lining of this tube. The buildup causes chronic inflammation (swelling) in the esophagus, which can lead to EoE symptoms.
What causes EoE?
When a person suffers from EoE, their immune system floods the esophagus with white blood cells in response to triggers such as certain food and environmental allergens that touch the esophageal lining. This abnormal immune system response is called type 2 inflammation.
Allergens such as pollen, mold, dust and animal dander can trigger EoE. However, the main cause of EoE is immune reactions to food.
Foods that can trigger EoE include:
- dairy products
- Peanuts and tree nuts
- Wheat
- Seafood/shellfish
- Eggs
- soy
Note: Not everyone with EoE reacts to the same foods, and tests cannot reliably predict which foods are triggers.
What are the symptoms of EoE?
EoE looks different at different ages. Babies and toddlers may not want to eat and may spit or vomit more often, have stomach pain, have trouble sleeping, and may not grow properly.
In older children and adults, the main symptoms of EoE are:
- Difficulty swallowing
- Food gets stuck in the throat after swallowing (impaction)
- heartburn
- Chest pain
- Stomach pain
- After swallowing, food comes back up (burping)
These symptoms may come and go, flare up every now and then, or they may occur permanently. Even if you don’t have any symptoms, you still have EoE because it is a lifelong, chronic condition.
Read: When my son was diagnosed with EoE, our family’s world was turned upside down >>
Who is affected by EoE?
EoE can affect anyone at any age, but certain risk factors can increase a person’s chances of developing the disease. Your chances of getting EoE are higher if you:
- Food allergies
- Environmental allergies (pollen, dust, animal hair, etc.)
- asthma
- Hay fever (allergic rhinitis)
- Eczema or other skin conditions that cause itchy, inflamed areas
- A family history of EoE or other allergic diseases
How do you diagnose EoE?
Because the symptoms of EoE are similar to those caused by other health problems that affect the esophagus, such as gastroesophageal reflux disease (GERD) or food allergy, diagnosis can be difficult.
If your healthcare provider (HCP) thinks you may have EoE, they will refer you to a gastroenterologist (GI doctor), a doctor who diagnoses, treats, and manages diseases of the digestive system. They will evaluate your symptoms and perform some tests, including:
- Upper endoscopy and biopsy: A long, thin tube (endoscope) with a light and camera is used to look at the lining of your esophagus and take samples to look at under a microscope. Endoscopy and biopsy are required for an EoE diagnosis.
- Blood tests: Blood tests will be done to check for allergens, higher than normal eosinophil counts, or other signs of an allergic reaction. Note that blood tests alone cannot reliably diagnose EoE or food triggers.
- Esophageal sponge: A tiny sponge attached to a string is used to remove tissue from your esophagus without the need for an endoscopy.
How do you treat EoE?
Although EoE has no cure and is a lifelong, chronic disease, it can be treated. Gastroenterologists treat and manage EoE. Your care team may also include allergists. Although they cannot diagnose or treat EoE themselves, they can help manage conditions associated with EoE, such as food allergies.
The best treatment for you depends on your individual health situation. Some of the treatment options for EoE are:
- Diet change such as avoiding certain foods that could trigger EoE.
- proton pump inhibitors (PPIs), These are medicines that reduce the production of stomach acid.
- steroids, These are medicines that help relieve inflammation. EoE is treated with liquid steroids that are swallowed so that they come into direct contact with the lining of your esophagus and relieve swelling.
- Biologics (monoclonal antibodies), A type of treatment that targets specific cells or proteins associated with inflammation, thereby reducing inflammation and improving swallowing.
- expansion of the esophagus, A procedure that uses endoscopy to dilate the esophagus to make swallowing easier, but does not treat the underlying inflammation. Dilation is usually used in conjunction with medication or dietary changes.
Treatments may change over time as your reaction and/or lifestyle changes. Therefore, you should regularly re-evaluate your treatment options with your HCP. Because symptoms alone cannot determine whether you respond to treatment, repeated endoscopies and biopsies are necessary to measure your response to treatment and disease activity or progression. You can work with your HCP to develop a plan for the ongoing management of your EoE.
Live your best life with EoE
If you think you may be having EoE symptoms – especially if you also have allergies, asthma, or other conditions that could put you at risk – talk to your doctor. Detecting EoE early will help prevent damage to your esophagus that can occur over time. And the sooner you get a diagnosis, the sooner you can start treating your EoE so you can feel better.
This educational resource was created with support from Regeneron, Sanofi and Takeda.
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