Last reviewed: June 2020
Last updated: May  2019



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 investigations

1st investigations to order

  • esophagogastroduodenoscopy
  • esophageal biopsy
  • CBC with differential
More 1st investigations to order

Emerging tests

  • transnasal endoscopy
  • esophageal string test
  • cytosponge
  • mucosal impedance
  • EoE diagnostic panel 
More emerging tests

Treatment algorithm


Consultant Paediatric Gastroenterologist

Chelsea and Westminster Hospital




JE is a member of the advisory board for Dr Falk, who make Jorveza, a new formulation of budesonide licensed for adults with eosinophilic esophagitis (EoE). She has received honoraria from Dr Falk to speak on EoE and been sponsored by Dr Falk to attend an academic meeting on EoE in Vienna in 2018.

Dr Jenny Epstein wishes to gratefully acknowledge Dr Evan S. Dellon, the previous contributor to this topic.

Peer reviewersVIEW ALL

Professor of Medicine

Mayo Clinic




DK has served on advisory boards (Adare, Receptos) and received research funding (Covidien).

Honorary Professor

Chief of the Division of Gastroenterology and Hepatology

First Department of Pediatrics

University of Athens

Agia Sofia Children’s Hospital




AP has received speaker’s honorariums from Nestle and Nutricia; research grants from Biogaia/Nutricia/Abbvie; consultant’s fee from Receptos.

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