Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- dysphagia
- food avoidance and modification behaviours
Other diagnostic factors
- heartburn
- chest discomfort
- nausea/vomiting
- regurgitation
- abdominal pain
- failure to thrive
- irritability
Risk factors
- family history of EoO
- male sex
- atopic disease
- children and younger adults
- white ancestry
Diagnostic investigations
1st investigations to order
- oesophagogastroduodenoscopy
- oesophageal biopsy
- FBC with differential
Emerging tests
- transnasal endoscopy
- oesophageal string test
- cytosponge
- Oesophageal physiological testing
- EoO diagnostic panel
Treatment algorithm
Contributors
Authors
Jenny Epstein, MB ChB MRCPCH PhD
Consultant Paediatric Gastroenterologist
Chelsea and Westminster Hospital
London
UK
Disclosures
JE is a member of the advisory board for Dr Falk Pharma, manufacturer of Jorveza, a new formulation of budesonide licensed for adults with eosinophilic oesophagitis (EoO), and Nurtricia for infant functional bowel disorders. She has received honoraria from Dr Falk Pharma to speak on EoO and has been sponsored by Dr Falk Pharma, Abbvie and Nutricia to attend national and international meetings. JE is a member of BSPGHAN IBD working group, medical advisor to CICRA and Coeliac UK, member of CCUK IBD working group, member of BSG EoE Guideline development group, member of NICE Guideline update committee for Crohn’s disease and ulcerative colitis, member of NICE Diagnostics, and sits on the NICE advisory committee for personalised treatment in Crohn's disease.
Acknowledgements
Dr Jenny Epstein wishes to gratefully acknowledge Dr Evan S. Dellon, the previous contributor to this topic.
Disclosures
ESD is an author of a number of references cited in this topic.
Peer reviewers
David Katzka, MD
Professor of Medicine
Mayo Clinic
Rochester
MN
Disclosures
DK has served on advisory boards (Adare, Receptos) and received research funding (Covidien).
Alexandra Papadopoulou, MD
Honorary Professor
Chief of the Division of Gastroenterology and Hepatology
First Department of Pediatrics
University of Athens
Agia Sofia Children’s Hospital
Athens
Greece
Disclosures
AP has received speaker’s honorariums from Nestle and Nutricia; research grants from Biogaia/Nutricia/Abbvie; consultant’s fee from Receptos.
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