What Are the Treatments for Eosinophilic Esophagitis?


While EoE can’t be cured, a number of treatments can help relieve symptoms. A type of medication called proton pump inhibitors (PPIs) controls the amount of acid in the stomach and can reduce inflammation and the number of eosinophils in the esophagus. Steroids also decrease inflammation, and leukotriene inhibitors can treat allergic reactions. These must be used with care in children, since they can have serious side effects.


For patients who have not responded or failed to see improvement on the above therapies, Dupixent is available as a treatment option. This is a monoclonal antibody that targets the underlying inflammatory pathways that contribute to EoE, effectively reducing esophageal inflammation. It is usually prescribed as a long-term treatment to manage chronic symptoms and prevent disease progression.


If strictures have narrowed the esophagus, medicines can sometimes relieve the problem. If medicines are not sufficient, we may use a procedure called endoscopic dilation to stretch the esophagus. If food becomes stuck in the throat, we use an emergency endoscopy to remove it quickly.


Since EoE is related to food allergies, many children and adults need to restrict their diets. At Orlando Health Arnold Palmer Hospital Center for Digestive Health and Nutrition, we start with a nutritional evaluation to determine which type of restriction will be best.


Depending on the results, your specialist may suggest one of the following:


  • Elimination diet. Removing foods that allergy testing has identified as causing a reaction.
  • Common allergen elimination diet. This removes the foods most likely to cause an allergic reaction. They include dairy foods, wheat, eggs, nuts, beef, fish, shellfish, corn and soy. These foods may be added back in one at a time. If so, an endoscopy may be done after each addition to make sure EoE is still controlled.
  • Elemental diet. This uses a hypoallergenic formula of simple sugars, oils and amino acids. The patient eliminates all foods except this formula for one to three months while their esophagus heals.


With any diet, we support your child with a blueprint for reintroducing foods in the future along with coaching and personalized care if a particular food causes problems.