In eosinophilic esophagitis, a type of white blood cell (eosinophil) builds up in the tube that connects your mouth to your stomach (esophagus) as a reaction to foods, allergens or acid reflux. When that happens, the eosinophils can inflame or injure the esophageal tissue.

  • Expertise. Mayo Clinic researchers were among the first in the United States to recognize eosinophilic esophagitis as a new disease. Mayo doctors have extensive expertise and experience treating this condition and other conditions of the esophagus.
  • Coordinated care. Specialists in digestive diseases (gastroenterology), immunology, allergic diseases and other areas work together to diagnose eosinophilic esophagitis and to develop a treatment plan for your needs.
  • Novel treatments. Mayo Clinic is actively involved in research on new therapies for eosinophilic esophagitis. This ongoing research means that in addition to standard eosinophilic esophagitis therapy, you may also have access to experimental treatments not available elsewhere.

A diagnosis of eosinophilic esophagitis is based in large part on a thorough review of your medical history and on your symptoms. In addition, Mayo Clinic doctors use the following procedures to help diagnose eosinophilic esophagitis:

  • Upper endoscopy. A long narrow tube (endoscope) containing a light and tiny camera is inserted through your mouth down the esophagus. Your doctor inspects the lining of your esophagus for signs of eosinophilic esophagitis, such as inflammation, horizontal rings, vertical furrows, narrowing (strictures) and white spots.
  • Biopsy. During endoscopy, your doctor will remove a small tissue sample from the lining of your esophagus for laboratory analysis. The presence of a high number of eosinophils in the tissue confirms the diagnosis for eosinophilic esophagitis.

A team of specialists work together to development a treatment plan for eosinophilic esophagitis tailored to your needs. Your treatment may involve:

  • Dietary therapy. If inflammation is caused by a food allergy, modifying your diet may be all you need to effectively treat eosinophilic esophagitis. To test for allergies, your doctor may perform a skin test or prescribe an elimination diet. An elimination diet requires you to stop eating foods that are common allergens, such as dairy foods, eggs, wheat, soy, nuts and fish. Those foods are then gradually added back into your diet, with your doctor monitoring you for reactions.
  • Medications. Steroid medications are effective for treating eosinophilic esophagitis. Usually, the type of steroid preparation used for this disease has little absorption into the blood, so there aren't many of the typical side effects often associated with steroids. Sometimes systemic steroids, such as prednisone, are used. Steroids may decrease the buildup of white blood cells in the esophagus, lessen the inflammation associated with an allergic reaction and allow your esophagus to heal.
  • Experimental therapies. Depending on your situation, you may have access to experimental treatments as part of Mayo Clinic's research on long-term management of eosinophilic esophagitis. Researchers are studying asthma medications (leukotriene receptor antagonists), acid-blocking medications and other medications for their effectiveness in treating the disease.

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Mayo Clinic in Arizona offers up-to-date diagnosis and treatment options for adults who have eosinophilic esophagitis. The treatment team includes doctors in Gastroenterology and Hepatology, Allergy, Asthma & Clinical Immunology and Community Internal Medicine, as well as other specialists as necessary.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

Mayo Clinic in Florida offers up-to-date diagnosis and treatment options for adults who have eosinophilic esophagitis. The treatment team includes doctors in Gastroenterology and Hepatology, Allergy and Consultative and Diagnostic Medicine, as well as other specialists as necessary.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

Mayo Clinic in Minnesota offers up-to-date diagnosis and treatment options for adults and children who have eosinophilic esophagitis. Eosinophilic esophagitis diagnosis and treatment involves doctors in Gastroenterology and Hepatology, Allergic Diseases and Pediatrics, with support from Clinical Biochemistry and Immunology, as well as other specialists as necessary.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

Mayo Clinic in Minnesota offers diagnosis and treatment in a child-friendly environment for children who have eosinophilic esophagitis. Specialists from Pediatric Gastroenterology and Hepatology and Allergic Diseases who have extensive experience in managing eosinophilic esophagitis work together to develop comprehensive treatment plans for children. In Mayo's efficient system, your child can see multiple specialists and receive testing and treatment in days, not months.

Children who have eosinophilic esophagitis may have different symptoms from those of adults, including:

  • Heartburn
  • Nausea
  • Vomiting
  • Diarrhea
  • Failure to thrive (poor growth, malnutrition and weight loss)
  • Chest pain
  • Poor appetite
  • Difficulty sleeping

Many children can be treated successfully through diet modification.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Mayo Clinic is a leader in eosinophilic esophagitis research and actively researches eosinophilic disorders. Mayo researchers have tested the effects of many medications on treatment, including:

  • Steroids
  • Asthma medications
  • Acid-blocking medications

Clinical trials are under way to study long-term management and remission of eosinophilic esophagitis.

Researchers at Mayo were the first to recommend that everyone with problems swallowing (dysphagia) have a biopsy to test for eosinophils, in addition to an upper endoscopy. Mayo was among the first medical centers in the United States to publish research demonstrating how the number of cases of the disease has increased more than tenfold in the last 30 years. Mayo doctors also have shown through their research the safety and effectiveness of endoscopic dilation on esophageal narrowing (strictures) in people who have eosinophilic esophagitis.

Mayo's Allergic Diseases Research Laboratory investigates the mechanisms of common airway and skin diseases. The lab focuses on and studies types of immune (white blood) cells, especially eosinophils. The laboratories in Clinical Immunology and Immunotherapeutics, Immunology, and Gastroenterology and Hepatology also are involved in research on eosinophilic disorders.

Publications

See a list of publications by Mayo Clinic doctors about eosinophilic esophagitis on PubMed, a service of the National Library of Medicine.

Nov. 19, 2012