Eosinophilic Esophagitis: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Eosinophilic Esophagitis?
A gastroenterologist, a doctor who treats digestive system problems, usually treats eosinophilic esophagitis. An allergist, a doctor who treats allergies, may also help look for food triggers. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is eosinophilic esophagitis?
Eosinophilic esophagitis (EoE) is a chronic disease of the esophagus. The esophagus is the muscular tube that carries food and liquids from your mouth to the stomach.
In EoE, white blood cells called eosinophils build up in the esophagus. This causes damage and inflammation, which can cause pain, trouble swallowing, and food getting stuck in your throat.
EoE was once thought to be rare. But NORD says it is no longer considered rare in the U.S. It is newly recognized and is diagnosed more often. Some people who think that they have reflux (GERD) may actually have EoE.
Symptoms
Symptoms depend on your age. In infants and toddlers, they include:
- Feeding problems.
- Vomiting.
- Poor weight gain and growth.
- Reflux that does not get better with medicines.
In older children, they include:
- Vomiting and belly pain.
- Trouble swallowing, especially with solid foods.
In adults, they include:
- Trouble swallowing, especially with solid foods.
- Food getting stuck in the esophagus.
- Heartburn and chest pain. Chest pain lasting two minutes or more needs emergency care.
- Reflux that does not get better with medicines.
Over time, EoE can cause narrowing of the esophagus, called a stricture.
Causes and who gets it
Researchers are not certain about the exact cause of EoE. They think it is an immune system or allergic reaction to foods or to things in your environment, such as dust mites, animal dander, pollen, and molds. Certain genes may also play a role.
Common foods that cause EoE include seafood, eggs, nuts, soy, wheat, and dairy.
EoE can affect anyone. It can affect both children and adults. It is more common in people who:
- Are male.
- Have other allergic diseases, such as hay fever, eczema, asthma, and food allergies.
- Have family members with EoE.
How doctors diagnose it
Your doctor will ask about your symptoms and medical history.
The doctor will likely do an upper GI endoscopy. An endoscope is a long, flexible tube with a light and camera at the end of it. Signs of EoE can include white spots, rings, narrowing, and inflammation in the esophagus. But not everyone with EoE has those signs.
During the endoscopy, the doctor takes small tissue samples from your esophagus, called a biopsy. The samples are checked for a high number of eosinophils. This is the only way to make a diagnosis of EoE.
You may have blood tests to check for other conditions. You may also have blood or other tests to check for specific allergies.
Treatment
There is no cure for EoE. Treatments can manage your symptoms and prevent further damage. The two main types of treatment are medicines and diet.
Medicines used to treat EoE include:
- Steroids, which help control inflammation. These are usually topical steroids that you swallow, either from an inhaler or as a liquid.
- Acid suppressors called proton pump inhibitors (PPIs), which may help with reflux symptoms and decrease inflammation.
- Monoclonal antibodies, which can reduce inflammation and may help with swallowing.
Sometimes doctors prescribe steroid pills for people with serious swallowing problems or weight loss. Topical steroids do not have the same side effects as oral steroids. You must rinse your mouth after using topical steroids.
Diet changes can also help. With an elimination diet, you stop eating and drinking certain foods for several weeks. If you feel better, you add the foods back one at a time. Repeat endoscopies show whether you are tolerating those foods.
With an elemental diet, you drink an amino acid formula instead of eating proteins.
Which treatment your doctor suggests depends on factors such as your age. If treatment is not working well enough and your esophagus is narrow, you may need dilation, a procedure to stretch the esophagus.
When to see a doctor
Contact your provider if you have symptoms of EoE. Reflux that does not get better with medicines is one symptom to mention.
Call 911 or go to the emergency room if you are choking, have trouble breathing, or have chest pain or discomfort lasting for two minutes or more. This includes trouble breathing when food is stuck in your throat.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can review your symptoms and help you decide when to see a specialist. They can also help with follow-up and keep your care team connected.
Common questions
Can eosinophilic esophagitis be cured?
No, there is no cure for EoE at this time. Treatment can manage symptoms and prevent further damage.
What foods can trigger eosinophilic esophagitis?
Common triggers include seafood, eggs, nuts, soy, wheat, and dairy. Allergy testing may find foods to avoid, but it is not always helpful. Talk to your provider about what foods to avoid.
Is eosinophilic esophagitis the same as acid reflux?
No, but the two can look alike. Some people who think that they have reflux (GERD) may actually have EoE. Reflux that does not get better with medicines is one symptom of EoE.
Can children get eosinophilic esophagitis?
Yes, EoE can affect both children and adults.
Does eosinophilic esophagitis go away?
No, it is a long-term disease.
Sources
- MedlinePlus - Eosinophilic Esophagitis
- MedlinePlus - Eosinophilic esophagitis (Medical Encyclopedia)
- NORD - Eosinophilic Esophagitis
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
