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What Is Eosinophilic Esophagitis?

Eosinophilic esophagitis, also known as EoE, is a chronic immune system disease. EoE can affect people of all ages but is more common in men. EoE causes white blood cells to gather in your esophagus. These cells are called eosinophils.  Over time, the inflammation and buildup of eosinophils can cause your esophagus to narrow. It can also cause the wall of your esophagus to not work properly.

What Causes EoE?

EoE is caused by an allergic reaction to certain foods. In rare cases, EoE is caused by environmental triggers, like pollen. The eosinophils (white blood cells) increase in your digestive tract in reaction to the allergen. The buildup of eosinophils and other immune cells causes your esophagus to become inflamed.

Inflammation over time can lead to narrowing (strictures) of your esophagus. It can also cause rings, furrows, or white patches. Damaged esophageal tissue can cause difficulty swallowing or cause food to get stuck when you swallow.


EoE and Gastroesophageal Reflux Disease (GERD) share many of the same symptoms, but there are key differences.

The main symptoms of GERD are heartburn and regurgitation. If you have GERD, you may feel like there is something always sitting in your throat that can’t be cleared. Acid reflux and inflammation are common signs of GERD.

The main symptoms of EoE are difficulty swallowing and food getting stuck in your throat or chest. In some cases, heartburn and regurgitation can occur as well. The presence of eosinophils in the esophagus is what makes EOE different from GERD.

Find an EoE Specialist Near Me

Symptoms of EoE

The most recognized symptom of EoE is difficulty swallowing (dysphagia). There are many symptoms of EoE:

  • Food impaction (food getting stuck in the esophagus)

  • Chronic heartburn

  • Upper abdominal pain

  • Chest pain

  • Acid reflux that does not respond to medication

  • Vomiting

Most Common EoE Triggers

EoE is often triggered by an allergic reaction to common foods:

  • Wheat

  • Dairy

  • Soy

  • Eggs

  • Peanuts or tree nuts

  • Fish or shellfish

Environmental allergies such as pollen can also trigger eosinophilic esophagitis. Many people with EoE have other allergic disorders like asthma, eczema, or environmental allergies.

Is EoE Genetic?

Eosinophilic esophagitis may run in families. If your family member has EoE, you have a greater chance of being diagnosed with EoE.

 People who live in a cold or dry climate are also more likely to have EoE. You are more likely to be diagnosed with EoE during the spring or fall when pollen levels are high.

What to Expect at Your Appointment

 At your first visit, you will meet with a GI specialist. Together, you will make plans on how to best proceed with your care. Depending on your situation, you may also meet with an allergist and or nutritionist at one of your clinic visits.

How Is Eosinophilic Esophagitis Diagnosed?

Eosinophilic esophagitis is diagnosed through biopsies (small tissues samples). A biopsy for EoE requires an upper endoscopy (EGD). 

An endoscopy involves passing a thin scope with a camera down your throat. Your provider will check for signs of inflammation and take biopsies to check for eosinophils.

Your provider will diagnose you with EoE if they find more than 15 eosinophils in your biopsy. The normal number of eosinophils in the esophagus is zero.

Treatment For EoE

There is not one treatment option for EoE. Your gastroenterology provider who specializes in EoE will help you get the care you need. Working together, you and your provider will discuss the best individual treatment options for your care.

Common treatment options include medication and avoiding foods that trigger EoE. Our team works closely with nutritionists. You can meet with a dietitian to discuss eliminating common food triggers. They will help you make meal plans to ensure you maintain optimal nutrition.

Why Choose University of Utah Health?

U of U Health has year-after-year exceptional rankings as offering the best health care in the nation. It's not a surprise. We believe collaboration throughout our system — from physicians, researchers, biologists, and more — leads to the most imaginative care.

Our team of gastroenterologists, APPs, and nutritionists work closely together to provide patients with the best team-based collaborative care. We also have ongoing research studies to help advance the field of EGID diseases. Patients have many opportunities to take part in our research.

EGID Clinic

The University of Utah Adult Eosinophilic Gastrointestinal Disease Clinic (EGID) specializes in the care and treatment of patients with eosinophilic gastrointestinal conditions. At EGID clinic visits, you will see a gastroenterologist and an allergist at the same appointment. Meeting with two specialists will ensure you receive the best care possible.

Understanding EGIDs is at the core of our clinic. We focus our clinical and research interests on ways to understand and treat EGID diseases. Our clinic participates in clinical trials which may interest you.