Eosinophilic Esophagitis: The Food-Related Allergy on the Rise
Back in the 1990s, doctors started noticing something unusual. A number of patients — many with allergies, asthma, or eczema — were struggling to swallow food. Some even found food getting stuck in their esophagus. This condition, now known as eosinophilic esophagitis (EoE), has since become one of the fastest-rising allergic disorders of the digestive tract.
What is EoE?
EoE is an allergic inflammation of the esophagus (the tube that carries food from your mouth to your stomach).
In teens and adults: It usually shows up as difficulty swallowing. Some people say food feels like it moves too slowly, or even gets stuck.
In kids: It may look more like reflux, belly pain, or vomiting.
Over time, untreated EoE can lead to scarring and narrowing of the esophagus, making swallowing even harder.
The trigger? In most cases, it’s food especially wheat, milk, eggs, soy, nuts, or seafood.
How is EoE diagnosed?
If your doctor suspects EoE, the next step is usually an upper endoscopy (a flexible tube with a camera that lets doctors see inside your esophagus).
Typical EoE signs:
Ring-like ridges inside the esophagus
Vertical lines or furrows
White patches or plaques
To confirm the diagnosis, doctors take small tissue samples (biopsies) and look for eosinophils — allergy-related immune cells that shouldn’t normally be there.
How common is it?
Right now, about 1 in 2,000 adults in the U.S. may have it — and the numbers are climbing.
Why the increase? Partly because we’re better at recognizing and diagnosing it. But studies also suggest there’s been a true rise in cases, especially since the early 2000s.
Why is EoE on the rise?
Doctors don’t have a single answer yet, but several theories exist:
The hygiene hypothesis: Growing up with fewer infections may mean the immune system is more prone to overreact to harmless things like food.
Microbiome alterations: Western diets and lifestyles may have altered our gut flora, which could lead to an increase in allergies.
Genetically engineered crops, food processing, additives, and pollution are examples of environmental exposures.Increased acid reflux: GERD can harm the esophagus, making it possible for allergens to enter.
Widespread usage of antacids: Early stomach acid reduction may have an impact on how the body develops tolerance to particular foods.
How is it handled?
Despite the lack of FDA-approved treatments specifically for EoE, doctors use the following main strategies:
Proton pump inhibitors (PPIs) are common antacids that help up to 50% of patients.
Ingested steroids: Like asthma drugs, these liquid steroids are consumed rather than inhaled in order to lessen esophageal irritation. Symptoms usually improve, but may reappear if trigger foods are continued.
Dietary elimination: For around eight weeks, patients refrain from eating common trigger foods (often starting with dairy and wheat), and then they gradually resume eating them while maintaining endoscopies and symptom monitoring.
Researchers are also creating new treatments, like improved steroid formulations and biologic drugs that target eosinophils more precisely.
The conclusion
If you have reflux, food sticking in your throat, or trouble swallowing that does not improve with traditional treatment, it is worth asking your doctor about EoE, especially if you also have allergies or asthma.
If treatment is not received, this disease may have long-term consequences. With the right treatment, which may involve medication or dietary changes, most patients can experience relief and long-term esophageal protection.
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