Eosinophilic Esophagitis (EoE) Treatment

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

At UVA Health Children’s, you can trust in our vast experience with this condition. We have the tools to get the right diagnosis. Some of these aren't currently 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 the 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 look at under a microscope. If your child has EoE, we'll find inflammatory cells, called eosinophils, in their esophagus. Eosinophils shouldn’t be in the esophagus, but they can be seen with both acid reflux and eosinophilic esophagitis. 

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. 

Elimination Diets

Most often, food is the primary trigger for EoE. And usually, more than 1 food. Discovering which foods are triggers, and avoiding those foods, is an effective treatment for many. 

The first step in identifying food triggers is to start an elimination diet. That means removing the most common triggers from your child's diet. At UVA Health Children’s, our nutritionists can help you develop meals that avoid these food triggers.  Once we determine that the EoE is treated, your child will introduce these foods back, one at a time. This process can help us identify the food triggers that should be avoided to manage your child’s symptoms.

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.

Medications for EoE Symptoms

In some cases, triggers can’t be totally avoided or it's not the right treatment approach for your child or family. That’s when medicines become part of your child’s treatment plan. Some of these medicines include:

• Acid-blocking agents
• Topical steroids
• Biologics

Therapeutic Endoscopy

Sometimes, EoE can cause the esophagus to narrow. This can make it even harder to eat. 

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