Children's Hospital Colorado

Eosinophilic Esophagitis (EoE) Treatment for Children and Teens

We pioneer and deliver some of the most groundbreaking treatments available for digestive disorders in children of all ages.

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Although there isn’t a cure for EoE, treatment can help kids manage symptoms and control the inflammation in their esophagus. Specialists with the Gastrointestinal Eosinophilic Diseases Program at Children’s Hospital Colorado work closely with families to create a custom treatment plan that meets your child and your family’s specific needs.

How we treat EoE

The two most common EoE treatment methods are dietary therapy and medication. Because food allergies trigger this condition, many kids with EoE need to watch what they eat to control their symptoms. Medication can help reduce inflammation in the esophagus, allowing food to more easily pass through it. We may recommend one or both of these treatment methods for your child.

More severe forms of EoE may cause the esophagus to narrow and develop scar tissue called strictures. In this case, treatment may include dilating, or stretching, the esophagus.

Dietary therapy for EoE

There are several types of dietary therapy, each discussed in more detail below. We work closely with your family to choose the diet that is most appropriate for your child and that maximizes their quality of life.

Elemental diet

This option requires removal of all regular food and drink from a child’s diet, and they drink only a hypoallergenic formula, such as the amino-acid based Neocate or Elecare. This diet is limiting and has a significant impact on quality of life, but it is the most effective diet treatment. Approximately 90% to 95% of children respond to this diet.

Testing-directed diet

Several assessments, such as a skin prick or blood test, help identify a child’s food allergies. Although positive tests do not necessarily mean a specific food is triggering a child’s EoE, we proactively remove these foods from their diet. Response can vary, with symptoms improving in 45% to 60% of children. An allergist from our Allergy and Immunology Center will discuss food allergy testing with you during your consultation.

Empiric elimination diet

Because allergy testing isn’t always accurate, an empiric elimination diet is often used to pinpoint specific EoE triggers. There are several variations, explained below. Each requires the removal of foods known to trigger EoE.

One-food elimination diet

Cow’s milk, or dairy, is the most common EoE trigger. A one-food elimination diet includes removal of all cow’s milk products, including baked goods, yogurt, cheese and ice cream in addition to cow’s milk itself. Studies show that approximately 60% of children respond to this diet.

Two-food elimination diet

This requires removal of all cow’s milk and wheat products. Studies show that approximately 45% of patients respond to this diet.

Four-food elimination diet

This requires removal of all cow’s milk, wheat, egg and soy. Studies show that approximately 65% of patients respond to this diet.

Six-food elimination diet

The six-food elimination diet requires removal of all cow’s milk, wheat, egg, soy, peanuts and tree nuts, and fish and shellfish. Studies show that approximately 72% to 74% of patients respond to this diet.

What to expect at your visit

An allergist will review your child’s medical history and current diet, including any existing foods they may already be avoiding due to anaphylactic food allergies, celiac disease or another condition. The allergist will also discuss which dietary therapy approach may be best for your child.

Getting started on an elimination diet

Our registered dietitians can help you find a diet that controls your child's symptoms while providing nutrients for their growing body.

Get their tips

Medication therapy for EoE

Inhaler management for EoE

Topical corticosteroids, such as fluticasone or budesonide, were originally developed for asthma patients but can also provide relief for children with EoE. Kids and teens can take the steroid as a liquid or from an inhaler. The steroid coats the esophagus, decreasing the number of eosinophils and allowing the esophagus to heal. 

Learn about how to use an inhaler or topical steroid for EoE in a video series.

Monitoring EoE treatment

Our team uses a procedure called an endoscopy to monitor EoE treatment progress. At Children’s Colorado, we’ve also developed two new procedures that are more comfortable for patients who need to receive endoscopies more frequently: the transnasal endoscopy and the esophageal string test Both of these methods achieve the same results as a normal endoscopy, but they don’t include any sedation or anesthesia. They also take less time to perform and have a much shorter recovery time. Learn about the transnasal endoscopy process through Haylie’s experience with the procedure and see how simple an esophageal string test is in our overview video.

What to expect from EoE treatment

EoE is a lifelong condition, which means it requires lifelong treatment. We carefully evaluate treatment methods, weighing the risks and benefits to ensure the best possible quality of life for your child. Our providers are here to help for the long term, both through in-person visits to Children’s Colorado and by coordinating care with your child’s primary provider.

We understand that lifestyle and dietary changes can be challenging for your child and family, which is why our multidisciplinary team includes psychologists, feeding therapists and registered dietitians. These pediatric specialists help support patients and families on an ongoing basis to ensure the lifestyle transition is manageable and as comfortable as possible.

Frequently asked questions about EoE treatment

Receiving a diagnosis for a chronic condition like EoE comes with many questions. We’ve answered several of the most common questions below.

Contact us

We accept EoE treatment referrals from across the nation. To get in touch, call 720-777-7457.

Looking for a second opinion?

Whether you’re still searching for a diagnosis or exploring treatment options for your child, we’re here to help. Learn how to request a second opinion from U.S. News & World Report’s #3 pediatric gastroenterology and gastrointestinal surgery program.

Request a second opinion from our Digestive Health Institute