Eosinophilic oesophagitis in children

Eosinophilic oesophagitis in children can present from infancy onwards; however, most children are school-aged at diagnosis. Clinical features vary according to the age of the child. Most children present with persistent regurgitation and symptoms of gastro-oesophageal reflux disease. Young children may also present with feeding difficulties or overt oral aversion. Older children and adolescents may also present with dysphagia or food impaction.

Eosinophilic oesophagitis is a key differential diagnosis in children with recurrent or persistent symptoms of gastro-oesophageal reflux disease, and in children with symptoms that do not respond to proton pump inhibitor (PPI) therapy. Referral to a paediatric gastroenterologist is recommended if eosinophilic oesophagitis is suspected. Diagnosis is confirmed by endoscopy and biopsy.

Specialist management may include topical corticosteroids, PPI therapy or dietary therapy under the care of a paediatric gastroenterologist or allergist.