Hope & Histamine: The Paediatric Allergy Podcast

Eosinophilic Oesophagitis (EoE) Explained: Pathophysiology, Diagnosis, and Modern Treatment Strategies

Goodlife Creations Season 2 Episode 24

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In this episode of Hope & Histamine: The Paediatric Allergy Podcast, we explore Eosinophilic Oesophagitis, or EoE— an increasingly recognised allergic inflammatory condition of the oesophagus that can affect feeding, swallowing, growth, and quality of life in children and young people.

We break down the pathophysiology of EoE, including the role of food allergens, type 2 inflammation, eosinophils, epithelial barrier dysfunction, and immune signalling pathways. The episode also covers how EoE presents in different age groups, from feeding difficulties and reflux-like symptoms in younger children to dysphagia, food impaction, and avoidance behaviours in older children and adolescents.

We discuss the key steps in diagnosing Eosinophilic Oesophagitis, including clinical suspicion, endoscopy, oesophageal biopsies, histological criteria, and the importance of excluding other causes of oesophageal eosinophilia. The episode then moves into practical treatment strategies, including proton pump inhibitors, swallowed topical steroids, dietary elimination approaches, multidisciplinary care, monitoring response, and emerging therapies such as biologics.

This episode is ideal for paediatricians, allergy clinicians, gastroenterologists, nurses, dietitians, trainees, and parents who want a clear, practical, and evidence-informed overview of EoE in children.

Sources:

  1. Dhar, A., Haboubi, H.N., Attwood, S.E. et al. (2022) 'British Society of Gastroenterology (BSG) and British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) joint consensus guidelines on the diagnosis and management of eosinophilic oesophagitis in children and adults', Gut, 71, pp. 1459–1487.
  2. Mahon, M., Muir, A.B. and Lynch, K. (2026) 'Eosinophilic oesophagitis: pathophysiology, diagnosis, and treatment', BMJ Medicine, 5, p. e001459.


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