Eosinophilic Esophagitis (EoE) Treatment

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If your child is having trouble eating, most likely the cause isn't a medical one. But if your child has pain, refuses their favorite foods, or has problems swallowing, they might have eosinophilic esophagitis (EoE).

Diagnosing and treating EoE is tricky. At UVA Health Children’s, you can trust in our vast experience with this condition. We have the tools to get the right diagnosis, as well as treatments not available anywhere else in the region.

Diagnosing Your Child’s EoE

The only reliable way of diagnosing eosinophilic esophagitis is with an upper endoscopy.

During upper endoscopy, a flexible tool with a camera (endoscope) goes into your child’s upper airway. There, the doctor can see swelling and collect samples of tissue to test with a biopsy. If your child has EoE, we'll find inflammatory cells, called eosinophils, in their esophagus. Eosinophils shouldn’t be in the esophagus, but GERD or EoE can cause them. 

Your child might find this diagnostic test scary. At UVA Health Children's, our compassionate team knows how to work with children to help them feel comfortable with procedures like this. 

Treating EoE at UVA Health Children’s 

EoE is a lifelong condition. But treatment and management can help. 

Identifying & Avoiding Triggers

Often, food allergies can cause EoE. Knowing what triggers the allergy and avoiding those foods helps control symptoms.

The first step is to identify the foods causing the allergic symptoms. If our allergists can identify a few foods that your child is allergic to, we can modify their diet. Without these foods, symptoms should improve. Our nutritionists can help you develop meals that avoid these food triggers.

Avoiding Common Allergens With an Elimination Diet

Sometimes, allergy tests don’t pick up everything. If your child’s test doesn’t show obvious results, we can still try an elimination diet. You'll remove the most common allergens (dairy, egg, wheat, soy, fish, and nuts) from your child's diet. Then, you'll add one of these foods back in, one at a time. This process can help us spot the food to which your child is allergic. 

Elemental Diet

This approach requires you to feed your child a special formula that supplies 100% of your child’s nutritional needs. We restrict all food, and then gradually reintroduce foods until we identify the ones responsible for your child’s EoE. In some cases, a g-tube is needed to get enough formula.

Medication for EoE Symptoms

In some cases, triggers can’t be totally avoided. That’s when medicines become part of your child’s treatment plan. Some of these medicines include:

  • Topical steroids
  • Corticosteroids
  • Acid-blocking agents
  • Proton pump inhibitors

Therapeutic Endoscopy

Sometimes, EoE can cause the esophagus to narrow. This can make it even harder to eat. Your child's breathing might be affected, too.

Therapeutic endoscopy can help widen your child’s esophagus again. We can use endoscopy to perform this procedure.

A young boy in a hospital gown ready for medical procedure

Unsedated Endoscopy

Many parents worry about the risk of repeat sedation on their child. UVA Health Children’s is excited to be able to offer these patients the option of unsedated endoscopy.

Learn More About Unsedated Endoscopy

Living with EoE

While EoE is a lifelong condition, many patients are surprised to find how manageable it is once the symptoms are controlled. For some children, the anxiety around eating outlasts the symptoms.

If your child no longer has inflammation but still struggles with food, our feeding encouragement program can help.