Eosinophilic oesophagitis (EoE) is a chronic allergic inflammatory condition in which a type of white blood cell — called an eosinophil — accumulates in the lining of the oesophagus (the food pipe). This causes the oesophagus to become inflamed and, over time, can make it narrow and stiff.

EoE was once considered rare, but is now one of the most common causes of difficulty swallowing in children and adults.

What Causes EoE?

EoE is driven by an allergic response to certain foods — most commonly milk, wheat, egg, soy, nuts, and seafood. Unlike IgE-mediated food allergies (where reactions happen within minutes), EoE is a delayed hypersensitivity reaction, making it harder to identify which foods are responsible.

Many children with EoE also have other allergic conditions such as asthma, eczema, or hay fever.

Symptoms of EoE in Children

Symptoms depend on age:

Infants and toddlers:

School-age children:

Older children and teenagers:

How Is EoE Diagnosed?

EoE cannot be diagnosed from symptoms or blood tests alone. The gold standard is:

The endoscopy may show characteristic features such as rings, furrows, or a pale coating in the oesophagus.

Treatment Options

Treatment aims to reduce inflammation and prevent complications:

Management of EoE is long-term and requires regular endoscopic monitoring to assess treatment response.

If your child is experiencing difficulty swallowing or recurrent food impaction, early assessment is important. Contact your GP for a referral to Dr Harveen Singh FRACP at our Sydney clinics.

Last reviewed by Dr Harveen Singh FRACP, Paediatric Gastroenterologist & Hepatologist