Duke Health gastroenterologists specialize in diagnosing and treating eosinophilic esophagitis (EoE), an allergic condition that causes inflammation in the esophagus. EoE usually causes difficulty swallowing and chest pain. Over time, the inflammation can narrow the esophagus, the tube connecting the mouth to the stomach. In some cases, food can become stuck. Choking is a medical emergency that requires immediate care.

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Understanding Eosinophilic Esophagitis

Eosinophilic esophagitis occurs when eosinophils and other types of white blood cells accumulate in the esophagus, usually due to an allergic response to a food or other allergens. The allergic reaction can cause inflammation in the lining of the esophagus. Over time, that can damage the esophagus. EoE can also cause heartburn and regurgitation, nausea, and abdominal pain.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Diagnosing Eosinophilic Esophagitis

Upper Endoscopy

An upper endoscopy is the most common way to diagnose eosinophilic esophagitis. Your gastroenterologist will insert a flexible lighted tube called an endoscope into your mouth to look for inflammation in your esophagus.

Endoscopic Biopsies

During the endoscopy, your gastroenterologist will remove small tissue samples to view under a microscope to look for inflammation in the esophagus.

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Treating Eosinophilic Esophagitis

Your gastroenterologist may coordinate your care with other providers to ensure that any additional allergic conditions, such as seasonal allergies, are well controlled. Your gastroenterologist may also recommend one or more of the following treatments.

Proton Pump Inhibitors (PPI)

PPIs work for EoE by blocking the immune response that moves the eosinophils into the esophagus.

Swallowed Steroid Medications

Swallowed steroids coat the esophagus to reduce inflammation. One is specifically designed and approved to treat EoE.

Biologic Medication

Regular injections of a biologic medication approved to treat EoE reduce inflammation in the esophagus. Biologics target specific parts of your immune system.

Esophageal Dilation

A dilation procedure may be performed when EoE results in a narrowing of the esophagus. During an endoscopy, a balloon or tool is passed into the esophagus and then inflated to stretch or widen the esophagus. This procedure does not reduce the inflammation in the esophagus.

Consistently Ranked Among the Nation’s Best Hospitals

Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are once again recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 10 pediatric specialties by U.S. News & World Report for 2024–2025.

Why Choose Duke

A Dedicated Esophageal Clinic
Seeking care at a dedicated esophageal clinic means you will benefit from a team of providers including gastroenterologists specializing in EoE and other esophageal disorders. Managing your care may require regularly scheduled visits. Our esophageal specialists work together so you receive the comprehensive care you need.

Extensive Experience in Eosinophilic Esophagitis
Doctors refer their patients to us because of our extensive experience diagnosing and treating eosinophilic esophagitis. Our gastroenterologists have completed specialized training and are highly skilled in endoscopy to diagnose and monitor EoE and other esophageal disorders. 

Access to Clinical Trials
You may be eligible to participate in our ongoing clinical trials, which test new therapies and approaches to treat eosinophilic esophagitis and related conditions. 

Dedicated Care Coordinators
Our care coordinators and social workers help you navigate every aspect of your care, including appointment scheduling, insurance coverage, and access to support resources.

World Allergy Organization (WAO) Center of Excellence 
As a WAO Center of Excellence, Duke is recognized for its clinical innovation, research and excellence in education and training.

This page was medically reviewed on 03/29/2024 by