Could it be EoE?
Think you have EoE?
If you think you have EoE, you probably have a lot of questions. Hopefully, we can help you find the answers you need here. We have information about what it means to live with EoE, and some of the common signs and symptoms of the condition.
If it all sounds very familiar to you, it could be EoE. Speak with your doctor about your symptoms as soon as possible, so you can start getting the help and support you need.
Recognize the signs and symptoms of EoE
Do these symptoms sound familiar?
Difficulty swallowing (dysphagia)
Food feeling stuck in your throat (impaction)
Heartburn
Chest pain
Coughing
Vomiting
If you're having difficulty swallowing food at mealtimes, the all-in-one EoE tracker can help you monitor your symptoms and support treatment conversations with your doctor.
Changing your eating habits
If you’re having difficulty swallowing, you may have changed the way you eat to try and manage your symptoms.2 Here are some examples of the ways people living with EoE sometimes change their eating habits – see if you can relate to any of the IMPACTS behaviors3:
Imbibing fluids with meals
you need a drink or lots of sauces/condiments to help the food go down
Modifying food
you cut up your food into tiny pieces
Prolonging mealtimes
you take a long time to eat your meal and are often the last to finish
Avoiding certain foods or events
you avoid hard-texture foods like bread or meat, or skip food-related events
Chewing excessively
you need to chew your food for a long time
Turning away tablets
you avoid taking pills and prefer liquid medications
Social impairment
you avoid going out to eat, or eating in public
Adapting how you eat can make mealtimes easier – but the problem with these tactics is that you can get used to them. Over time, these eating habits could hide important changes in your symptoms, and prevent you from noticing that your EoE symptoms have become worse.
This is because these food "workarounds" aren’t treating the Type 2 inflammation that causes your symptoms, and they won't stop it getting worse. The longer this inflammation goes untreated, the worse your condition can become, and the more damage it could be doing to your esophagus.2,4,5
Do I have EoE?
If the symptoms and behaviors mentioned above sound familiar, it could be EoE. It’s important that you speak with your doctor as soon as possible. Getting an early diagnosis may help make the condition easier to manage.6
It can be hard to track your symptoms over time, find the right words, or even remember what to ask during your doctor’s appointment. Our EoE adult toolbox can make sure you’re fully prepared when you speak to your doctor about EoE.
Is it EoE or something else?
Because the symptoms are so similar, EoE is often mistaken for more common conditions like food allergies or GERD – gastroesophageal reflux disease, also known as "acid reflux" or "heartburn."7
However, EoE is a distinct medical condition that needs to be managed differently. This often means different doctors have to work together to help you get the correct diagnosis, treatment, and care.
The inflammation that drives EoE is also linked to other conditions. If you’re living with EoE, you may also have other allergies, atopic dermatitis (eczema), or allergic rhinitis (hay fever), which also have similar symptoms.8,9
How EoE differs from GERD
GERD is caused by stomach acid flowing back into the esophagus, causing heartburn, irritation, and difficulty swallowing.7,10 Although symptoms may overlap in EoE and GERD, they’re treated differently.7,11,12
How EoE differs from food allergies
Although certain foods can make your EoE symptoms worse, having EoE is different from having a food allergy.13
EoE can be triggered by allergens, but unlike typical food allergies that cause immediate reactions, EoE symptoms can take several days to appear. This delay makes it harder to identify what's causing your symptoms.1,13
Getting a diagnosis
EoE is a long-term (chronic) condition that can have ongoing effects, but it often goes undiagnosed.7,14 EoE is progressive, meaning that the symptoms and inflammation can worsen over time.5,15,16 If left untreated, this can result in further narrowing and scarring of the esophagus, which makes it difficult and uncomfortable to eat.5,16
Having EoE can affect not just your body but your overall life, so if you suspect you may have it, it’s important to get diagnosed and treated early.15,17
Diagnosis will involve a consultation with your doctor to check if other conditions can be ruled out.
Our EoE adult toolbox has everything you need to be better equipped when speaking to your doctor about EoE.
Gastroenterologists help with your EoE diagnosis
If you speak to your doctor about EoE and they think you or a loved one may have the condition, you’ll need to be referred to a gastroenterologist, or GI doctor for short. Sometimes patients with symptoms may go to an Ear, Nose, and Throat (ENT) doctor; however, the diagnosis and management of EoE typically involve a GI doctor.18
GI doctors specialize in the health of the digestive system – including the esophagus, stomach, and intestines.19
To diagnose EoE, your gastroenterologist will perform an endoscopy to observe the inside of your esophagus. This is done using a thin flexible tube with a camera on the end (an endoscope) that the doctor will gently insert into your esophagus, usually while you are sedated.1
They will then take tiny samples of tissue (biopsies) from your esophagus to send away to a laboratory to confirm the presence of excessive eosinophils (a type of white blood cell) that indicate whether you have EoE.20
Gastroenterologists may also use other tests to help confirm EoE.19
References
- Gonsalves NP and Aceves SS. J Allergy Clin Immunol 2020; 145(1): 1–7.
- Gonsalves NP. Dig Dis 2014; 32(1–2): 89–92.
- Hirano I and Furuta GT. Gastroenterology 2020; 158(4): 840–851.
- Muir AB et al. Clin Exp Gastroenterol 2019; 12: 391–399.
- Dellon ES and Hirano I. J Gastroenterol 2018; 154(2): 319–332.e2.
- Muir AB and Falk GW. JAMA 2021; 326(13): 1310–1318.
- Lenti MV et al. Dig Liver Dis 2021; 53(12): 1632–1639.
- Chehade M et al. J Allergy Clin Immunol Pract 2018; 6(5): 1534–1544.
- Van Rhijn BD and Bredenoord AJ. J Clin Gastroenterol 2017; 51(8): 659–668.
- Wong S et al. World J Gastrointest Pathophysiol 2018; 9(3): 63–72.
- Katz PO et al. Am J Gastroenterol 2022; 117: 27–56.
- Hirano I et al. Gastroenterology 2020; 158: 1776–1786.
- American Academy of Allergy Asthma & Immunology. Eosinophilic Esophagitis. Available at: https://www.aaaai.org/conditions-treatments/related-conditions/eosinophilic-esophagitis Accessed October 2024.
- Dellon ES. Gastroenterol Clin North Am 2014; 43(2): 201–218.
- Lucendo AJ et al. United Eur Gastroenterol J 2017; 5(3): 335–358.
- Bredenoord AJ et al. Am J Gastroenterol 2022; 117(8): 1231–1241.
- Pokrzynwinski R et al. Adv Ther. 2020; 37: 4458–4478.
- John Hopkins Medicine. Eosinophilic Esophagitis. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/eosinophilic-esophagitis Accessed November 2024.
- American College of Gastroenterology. What is a Gastroenterologist? Available at: https://gi.org/patients/gi-health-and-disease/what-is-a-gastroenterologist/ Accessed October 2024.
- Dellon ES, et al. Am J Gastroenterol. 2024; 120: 31–59.