Eosinophilic Esophagitis in Children

What is eosinophilic esophagitis?

Eosinophilic esophagitis is an allergic condition that causes inflammation and damage to the esophagus, the muscular tube that connects the mouth to the stomach. It is usually caused by a food allergy and can affect your child's ability to eat, both physically (a swollen esophagus makes it hard for food to go down) and psychologically (a child may grow to associate eating with discomfort).

What are the symptoms of eosinophilic esophagitis?

Children with eosinophilic esophagitis develop inflammation and swelling in the esophagus. The inflammation can lead to a variety of symptoms ranging from discomfort with feeds to vomiting and food impaction.

While each child may experience symptoms differently, common signs of eosinophilic esophagitis include:

  • difficulty swallowing (dysphagia)
  • food getting stuck in the throat (impaction)
  • chest pain
  • vomiting
  • poor weight gain
  • refusing to eat (especially in toddlers)
  • increased sensitivity to food texture

It's important to remember that none of these symptoms points definitively to eosinophilic esophagitis and many of the symptoms can overlap with other conditions such as gastroesophageal reflux disease. While eosinophilic esophagitis is most common in children with other allergic conditions (such as asthma, eczema and classic food allergies), it can also occur in healthy children and adults. That's why it's important that your child is diagnosed by specialists who have a lot of experience with eosinophilic esophagitis and how it appears in children.

What causes eosinophilic esophagitis?

Eosinophilic esophagitis is an allergic condition that most often involves a reaction to food. Foods that are most commonly associated with eosinophilic esophagitis include milk and other dairy products, wheat, eggs, soy, peanuts, tree nuts, fish and shellfish.

How we care for eosinophilic esophagitis

At Boston Children's Hospital, allergists, nurse practitioners, registered dieticians, clinical social workers and other specialists work together to provide care for children and adolescents with eosinophilic esophagitis and other eosinophilic gastrointestinal diseases. There is no one-size-fits-all therapy for eosinophilic esophagitis. Options to manage it include both medication and diet restrictions, for which we advocate a team approach with specialists from many different disciplines. Both the Eosinophilic Gastrointestinal Disease Program and Aerodigestive Center offer evaluation and treatment of eosinophilic esophagitis at Boston Children's.