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What is eosinophilic oesophagitis?
Eosinophilic oesophagitis (EoE) is a long-term condition affecting the oesophagus (food pipe).
It happens when a type of white blood cell called an eosinophil builds up in the lining of the oesophagus, usually as a reaction to certain foods or allergens.
It is thought that certain foods trigger a reaction in the body. This causes eosinophils to build up in the oesophagus. This is not a typical food allergy, because it only affects the oesophagus.
The food that causes the problem is not always the food that gets stuck. l Cow’s milk is a common trigger, but it is a liquid so does not usually get stuck l Foods like meat or bread are more likely to get stuck because of their texture.
Over time, this can cause inflammation and make the oesophagus narrower.
What are the symptoms?
Common symptoms include:
- Difficulty swallowing (especially solid foods)
- Food getting stuck in the throat (food bolus obstruction)
- Chest discomfort or pain
- Persistent heartburn or reflux symptoms
- Slow eating or needing to drink a lot with meals
Some people may adapt their eating habits without realising (e.g. chewing excessively or avoiding certain foods).
What causes EoE?
EoE is often linked to:
- Food allergies (such as milk, wheat, eggs, or soy)
- Other allergic conditions (e.g. asthma, eczema, hay fever)
It is not contagious and cannot be passed to others.
How is it diagnosed?
Diagnosis usually involves a test called an endoscopy (OGD).
During this test:
- A thin flexible tube with a camera is passed down your throat
- Small samples (biopsies) are taken from the oesophagus
These samples are examined under a microscope to confirm EoE.
How is it treated?
Treatment aims to reduce inflammation and improve symptoms.
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Acid-reducing medication (PPI)
You may be given medication such as omeprazole to reduce acid and inflammation.
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Steroid treatment
A commonly used treatment is:
- Jorveza (budesonide)
This is a tablet that melts on your tongue and coats the oesophagus.
How to take it:
- Let the tablet dissolve slowly on your tongue
- Do not eat or drink for 30 minutes afterwards
-
Dietary treatment
Some patients benefit from removing certain foods from their diet.
Common approaches:
- Removing 2 foods (usually milk and wheat)
- Removing more foods if needed
You will usually be supported by a dietitian.
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Stretching the oesophagus (dilatation)
If the oesophagus has become narrowed, a procedure may be done to gently stretch it.
Will I need follow-up?
Yes. EoE is a long-term condition.
You may need:
- Repeat endoscopies
- Ongoing medication or diet changes
- Regular clinic reviews
What can I do to help myself?
- Eat slowly and chew food well
- Take small bites
- Drink fluids with meals
- Avoid foods that trigger symptoms
- Take medications as prescribed
When should I seek urgent help?
Go to A&E if:
- Food becomes stuck and will not pass
- You cannot swallow saliva
- You have severe chest pain
Are there any side effects from treatment?
Most treatments are well tolerated.
With steroid treatment, possible side effects include:
- Oral thrush (fungal infection in the mouth)
- Mild sore throat
Rinsing your mouth after taking medication can help reduce this risk.
Further information and support
If you have any concerns, please contact:
- Your Gastroenterology team
- Your GP
This page is intended as general guidance and does not replace medical advice from your healthcare team.
Always ask anything you wish, no questions are trivial or ‘silly’. The person you ask will do their best to answer but, if they don’t know, they will find someone else who is able to discuss your concerns.
Contact us
If you have any queries relating to this information, please contact the Endoscopy service.
About this information
Service:
Endoscopy
Reference:
H/006
Approval date:
16 October 2026
Review date:
1 October 2029
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.