Symptoms of Eosinophilic Esophagitis

Eosinophilic Esophagitis

Eosinophilic esophagitis is a rare chronic condition that affects the muscular tube that connects the mouth to the stomach, known as the esophagus. People who have eosinophilic esophagitis experience an overgrowth of eosinophils, which are white blood cells, inside the esophagus. 

Eosinophils are part of the immune system. They normally work to fight infections in the body. The overgrowth seen in eosinophilic esophagitis is believed to be caused by an allergic response. This buildup of eosinophils on the lining of the esophagus leads to inflammation and injury. The most common symptom of eosinophilic esophagitis is difficulty swallowing.

This article will describe the common symptoms of eosinophilic esophagitis. It will also explain when to call the doctor or seek emergency treatment. 

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Frequent Symptoms in Adults

Eosinophilic esophagitis is a chronic immune condition that leads to swelling in the esophagus caused by the presence of eosinophils. Normally there are no eosinophils in the esophagus. Symptoms are caused by this chronic inflammation in the lining of the esophagus. Common symptoms in adults include:

  • Difficulty swallowing, known as dysphagia
  • Painful swallowing 
  • Feeling as though food is getting “stuck” in the throat
  • Vomiting or regurgitation of food
  • Chest pain or heartburn 
  • Difficulty eating hard or dense foods 

The feeling of food becoming stuck in the throat is known as food impaction. A 2020 study found that up to 50% of adults who seek treatment for food impaction are eventually diagnosed with eosinophilic esophagitis.

Eosinophils and GERD

Individuals with gastroesophageal reflux disease (GERD) also experience eosinophils in the lining of the esophagus. 

Frequent Symptoms in Children

When children experience eosinophilic esophagitis, their symptoms are slightly different from those in adults. Common symptoms in children include:

  • Decreased appetite 
  • Unable to eat or drink
  • Abdominal pain
  • Food regurgitation 
  • Nausea and vomiting
  • Fussiness or irritability
  • Failure to gain weight 
  • Reflux that does not improve with medication or treatment 
  • Difficulty sleeping 

Children do not commonly experience food impaction, or a feeling of food becoming stuck in the throat. However, children over the age of 12 are more likely to present with adult-like symptoms of eosinophilic esophagitis and are more likely to experience food impaction.

Rare Symptoms

Eosinophilic esophagitis can lead to life-threatening complications if left untreated. When food becomes lodged in the esophagus, this is known as food impaction. Food impaction makes it impossible to eat or drink and must be treated right away. This is especially true if the impacted food feels as though it is blocking your airway as well. 

Eosinophilic esophagitis can also cause chest pain. While this is a common symptom in adults, new-onset chest pain should never be ignored, as it could be a sign of heart disease. Call your doctor right away if you are experiencing chest pain. 

Complications

Eosinophilic esophagitis is a chronic condition and can lead to complications over time. Possible complications include:

  • Food impaction: This occurs when food becomes firmly stuck in the esophagus. 
  • Narrowing of the esophagus: Over time, eosinophilic esophagitis can cause scarring and narrowing of the esophagus. This may make swallowing food even more difficult. 
  • Esophageal tear: Eosinophilic esophagitis causes inflammation in the esophagus, and this may lead to tearing in the lining known as a perforation. 

When to See a Doctor/Go to the Hospital

See your doctor right away if you have developed symptoms of eosinophilic esophagitis. Your primary doctor will likely refer you to an allergist or gastroenterologist to diagnose and treat the condition. Eosinophilic esophagitis is considered to be a chronic condition. While it can be managed and controlled, there is no known cure. 

See your doctor any time you are experiencing new-onset chest pain. Because this can be a sign of heart disease, it’s important to address it right away. If you have been experiencing symptoms like heartburn for two weeks, see your doctor to learn what is causing it. 

Call 911 If You Are Having Trouble Breathing

Seek emergency medical care if you feel like you cannot breathe or that food is blocking your airway. This is an emergency and requires immediate treatment. 

Summary 

Eosinophilic esophagitis is a chronic immune condition that is characterized by a buildup of eosinophils in the esophagus. This buildup of white blood cells causes inflammation and leads to symptoms such as difficulty swallowing (dysphagia), heartburn, chest pain, and food impaction. Children experience slightly different symptoms, including nausea, vomiting, food regurgitation, and an inability to eat or drink. 

A Word From Verywell 

Experiencing eosinophilic esophagitis may feel frightening at first, especially if you do not know why food is becoming stuck in your throat. If you have developed symptoms of eosinophilic esophagitis, see your doctor and ask for a referral to an allergist or gastroenterologist. While there is no cure for this chronic immune disorder, diet changes and prescription medications can often manage it. 

Frequently Asked Questions

  • How is eosinophilic esophagitis treated?

    Eosinophilic esophagitis has been associated with food allergies and is often treated with elimination diets. Prescription medications such as proton pump inhibitors (PPIs), corticosteroids, or Dupixent (dupilumab) may also be prescribed. If those treatment options are not effective, esophageal dilation may be recommended. 

  • How do I know if I have eosinophilic esophagitis?

    The only way to diagnose eosinophilic esophagitis is with an upper endoscopy and biopsy. This involves placing a tube with a light and a camera down the esophagus to examine the tissue. During the endoscopy, tissue samples are taken and examined under a microscope to look for eosinophils and signs of inflammation. 

  • Is my chest pain caused by eosinophilic esophagitis?

    It is possible that your chest pain is caused by eosinophilic esophagitis, as chest pain and heartburn are common symptoms in adults. However, chest pain could also indicate heart disease and should never be ignored. If you are having chest pain, call your doctor or seek emergency treatment.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Organization for Rare Disorders. Eosinophilic esophagitis.

  2. MedlinePlus. Eosinophilic esophagitis.

  3. American Academy of Allergy, Asthma & Immunology. Eosinophilic esophagitis: Symptoms, diagnosis & treatment.

  4. Gonsalves NP, Aceves SS. Diagnosis and treatment of eosinophilic esophagitis. J Allergy Clin Immunol. 2020 Jan;145(1):1-7. doi:10.1016/j.jaci.2019.11.011

  5. Furuta GT, Katzka DA. Eosinophilic esophagitis. N Engl J Med. 2015 Oct 22;373(17):1640-8. doi:10.1056/NEJMra1502863

  6. O'Shea KM, Aceves SS, Dellon ES, Gupta SK, Spergel JM, Furuta GT, Rothenberg ME. Pathophysiology of eosinophilic esophagitis. Gastroenterology. 2018 Jan;154(2):333-345. doi:10.1053/j.gastro.2017.06.065

  7. American Partnership for Eosinophilic Disorders. EoE.

  8. Reed CC, Dellon ES. Eosinophilic esophagitis. Med Clin North Am. 2019 Jan;103(1):29-42. doi:10.1016/j.mcna.2018.08.009

  9. Feo-Ortega S, Lucendo AJ. Evidence-based treatments for eosinophilic esophagitis: Insights for the clinician. Therapeutic Advances in Gastroenterology. January 2022. doi:10.1177/17562848211068665

By Carrie Madormo, RN, MPH
Carrie Madormo, RN, MPH, is a health writer with over a decade of experience working as a registered nurse. She has practiced in a variety of settings including pediatrics, oncology, chronic pain, and public health.