Summary
Definition
History and exam
Key diagnostic factors
- dysphagia
- food avoidance and modification behaviors
Other diagnostic factors
- heartburn
- chest discomfort
- nausea/vomiting
- regurgitation
- abdominal pain
- failure to thrive
- irritability
Risk factors
- family history of EoE
- male sex
- atopic disease
- children and younger adults
- white ancestry
Diagnostic tests
1st tests to order
- esophagogastroduodenoscopy
- esophageal biopsy
- CBC with differential
Emerging tests
- transnasal endoscopy
- esophageal string test
- cytosponge
- Esophageal physiological testing
- EoE diagnostic panel
Treatment algorithm
at initial diagnosis
response to initial therapy
nonresponse or relapse
Contributors
Authors
Jenny Epstein, MB ChB MRCPCH PhD
Consultant Paediatric Gastroenterologist
Chelsea and Westminster Hospital
London
UK
Disclosures
JE is a member of the advisory board for Dr Falk Pharma, manufacturer of Jorveza, a new formulation of budesonide licensed for adults with eosinophilic esophagitis (EoE), and Nurtricia for infant functional bowel disorders. She has received honoraria from Dr Falk Pharma to speak on EoE and has been sponsored by Dr Falk Pharma, Abbvie and Nutricia to attend national and international meetings. JE is a member of BSPGHAN IBD working group, medical advisor to CICRA and Coeliac UK, member of CCUK IBD working group, member of BSG EoE Guideline development group, member of NICE Guideline update committee for Crohn disease and ulcerative colitis, member of NICE Diagnostics, and sits on the NICE advisory committee for personalized treatment in Crohn disease.
Acknowledgements
Dr Jenny Epstein wishes to gratefully acknowledge Dr Evan S. Dellon, the previous contributor to this topic.
Disclosures
ESD is an author of a number of references cited in this topic.
Peer reviewers
David Katzka, MD
Professor of Medicine
Mayo Clinic
Rochester
MN
Disclosures
DK has served on advisory boards (Adare, Receptos) and received research funding (Covidien).
Alexandra Papadopoulou, MD
Honorary Professor
Chief of the Division of Gastroenterology and Hepatology
First Department of Pediatrics
University of Athens
Agia Sofia Children’s Hospital
Athens
Greece
Disclosures
AP has received speaker’s honorariums from Nestle and Nutricia; research grants from Biogaia/Nutricia/Abbvie; consultant’s fee from Receptos.
Differentials
- Gastroesophageal reflux disease (GERD)
- Eosinophilic gastroenteritis
- Achalasia
More DifferentialsGuidelines
- Joint consensus guidelines on the diagnosis and management of eosinophilic oesophagitis in children and adults
- Practice guideline: adverse events associated with EGD and EGD-related techniques
More Guidelines
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