Treating a child with eosinophilic esophagitis (EoE) is a journey with both ups and downs. From allergy testing and endoscopies to trying food eliminations and elemental formula diets, the CHOC Children’s Eosinophilic Esophagitis Clinic team works with patients and their families to narrow down each child’s EoE triggers. 

After an endoscopy shows that the eosinophils have gone away, our team works with the patient’s family to reintroduce foods. The foods are selected according to previous allergy testing, nutritional quality, the child and family’s preferences and the expertise of the team. Foods are slowly reintroduced one at a time beginning with those negative on testing and/or least likely to cause a reaction. During this time, it is important for caregivers to monitor the patient for allergic reactions or EoE symptoms. Symptoms are usually similar to those that led to the child’s initial diagnosis and can range from mild reflux and food impaction to cramping, vomiting and difficulty swallowing. If there is known or suspected risk associated with the food, the reintroduction may be done under the supervision of the child’s healthcare team.

After a few foods have been reintroduced, patients undergo another endoscopy to see if the eosinophils have returned, even if the patient does not have obvious EoE symptoms. If there are no eosinophils, the child can continue eating those “safe foods.” If the eosinophils have returned, those foods are again removed. The food reintroduction process continues until the EoE team is able to determine the food(s) causing the allergic reaction. Once the team figures out which foods cause the child’s EoE symptoms, those foods are permanently eliminated from the patient’s diet. 

Food reintroduction can be exciting and overwhelming for patients and their families. Learn more about:

• The challenges of food reintroduction
• The facts about difficult eaters.
• How to handle feeding problems or children having difficulty incorporating food back into their lives.
• Knowing when it is time to get help with a difficult feeder.