Eosinophilic esophagitis may occur in children or adults. The disease in adults tends to occur in young males who present with dysphagia or an episode of food impaction in the esophagus.



(1) typically a young adult male, but may affect women and the elderly

(2) dysphagia with or without symptoms of reflux

(3) history of food impaction

(4) history of food allergy, asthma, atopy or allergy

(5) presence of (a) one or more esophageal rings or (b) stricture

(6) often mild eosinophilia in peripheral blood

(7) exclusion of other diagnosis (hypereosinophilic syndrome, drug reaction, etc.)


Histopathologic features in an esophageal biopsy (Parfitt et al):

(1) intra-epithelial eosinophils >= 25 in any 1 high powered field, or >= 15 in 2 or more high power fields

(2) eosinophilic microabscesses

(3) fibrosis in the lamina propria

(4) hyperplasia of the squamous epithelium (proliferative)


Other features:

(1) The condition may occur together with some degree of GERD.

(2) A case associated with food allergy will respond to elimination of the causative foods from the diet.

(3) Many patients will be initially be treated empirically for GERD but will undergo endoscopy when there is a suboptimal response to GERD therapy.


To read more or access our algorithms and calculators, please log in or register.