How is Eosinophilic Esophagitis Treated?

Treatment for eosinophilic esophagitis is complex and ideally involves a multidisciplinary team of healthcare professionals:

gastroenterologists (focus on esophageal damage and complications)
allergists (focus on allergic testing and identifying food triggers)
psychologists (work with patients and families to create healthy habits and coping skills)
dietitians (create a nutrition plan based upon patient’s dietary preferences)
feeding specialists (create short- and long-term treatment plans for healthy eating that work for the patient)

These healthcare professionals collectively provide the best care for patients with EoE. Additionally, there are several different approaches to treatment for EoE that are delivered separately by these specialists. Treatment for EoE includes one or more of the following three options:

Dietary Therapy

The diet of patients with EoE will be modified to identify and then avoid triggers of esophageal inflammation. Common triggers for patients with EoE are dairy, wheat, soy, and eggs. The type of dietary therapy used, such as an elemental diet (no allergens) or an elimination diet (fewer allergens), will be decided by the healthcare team working together with the patient and their family.

Medication

Two long-standing treatments for patients with EoE are proton pump inhibitors (PPIs) and topical steroids. Treatment with PPIs blocks acid production and helps the lining of the esophagus heal from inflammation. Patients can also be treated with topical steroids, which usually is a liquid mixture, absorbed into the esophageal lining to lower the level of inflammation. Budesonide oral suspension was approved in 2024 for 12 weeks of treatment in those aged 11 years and older with EoE. Dupilumab, which is an immunotherapy, is also effective by targeting the underlying source of inflammation. Dupilumab was approved in 2022 for the treatment of EoE in adults and adolescents, which was expanded in 2024 to include patients aged 1 year or older (weight > 15kg). Dupilumab was approved in 2022 for the treatment of EoE in adults and adolescents, which was expanded in 2024 to include patients aged 1 year or older (weight > 15kg). Additional therapies looking at different targets for EoE are also under investigation.

Dilation

Patients who are still having trouble swallowing food after taking topical steroids will benefit from having their esophagus dilated, or stretched to open wider.