Eosinophilic Esophagitis (EoE): A Patient Guide For Adults

What Is Eosinophilic Esophagitis?

Eosinophilic esophagitis—often called EoE—is a condition where the lining of the esophagus becomes inflamed due to a buildup of eosinophils (a type of white blood cell involved in allergic reactions).
This inflammation can make swallowing more difficult, cause food to feel “stuck,” or lead to heartburn-like symptoms that don’t fully improve with acid-reducing medications.

Common Symptoms of EoE

Trouble swallowing, especially solid foods
Food getting stuck in the throat or chest (“food impaction”)
Chest discomfort not related to the heart
Heartburn that does not improve with acid-reduction medications

Foods Commonly Avoided in EoE

Many foods that trigger EoE symptoms are related to allergies.
Your provider may recommend an elimination diet to help identify the specific triggers.

Most Common Food Triggers

Cow’s milk and dairy products
Wheat / Gluten-containing grains
Eggs
Soy (including soy protein, tofu, edamame) and other legumes
Peanuts and tree nuts
Seafood and shellfish

These categories make up the traditional six-food elimination diet often used to calm inflammation.

Foods Often Better Tolerated

These foods are typically easier to swallow and less likely to cause irritation or inflammation.

Gentle, “EoE-Friendly” Options

Soft foods: mashed potatoes, cooked cereals, oatmeal, grits, polenta
Moist proteins: ground turkey, flaky fish (if not eliminated), slow-cooked meats, scrambled eggs (if tolerated)
Dairy substitutes: oat milk, almond milk, coconut yogurt (if nuts are allowed)
Cooked vegetables: carrots, squash, zucchini, green beans
Ripe or soft fruits: bananas, applesauce, pears
Smooth nut-free alternatives: seed butters (sunflower seed butter)
Gluten-free grains: rice, quinoa, gluten-free pasta
Soups and stews (soft texture reduces risk of food sticking)

Texture Tips

Patients often tolerate foods better when they are:

Moist
Cut into very small pieces
Slow-cooked
Mixed with broth or sauce

⭐ Tips to Reduce Symptoms

These strategies are especially useful for those who may have slower swallowing reflexes or multiple medical conditions.

1. Chew slowly and thoroughly

Take your time—chewing well significantly reduces the risk of food sticking.

2. Take small bites and small sips

Eating slowly is one of the most effective ways to prevent food impaction.

3. Drink fluids throughout your meal

Warm beverages can help relax the esophagus.

4. Avoid lying down after eating

Stay upright for at least 1–2 hours.

5. Use sauces, broths, or gravies

Moist foods move more easily through the esophagus.

6. Consider an elimination diet under medical supervision

Especially important to follow your healthcare provider’s guidance due to:

Risk of unintentional weight loss
Medication interactions
Nutrient deficiencies

7. Follow medical treatment as directed by your healthcare provider

EoE is often treated with:

Topical (swallowed) corticosteroids (fluticasone, budesonide)
Proton pump inhibitors (PPIs)
Dietary elimination
Periodic endoscopy and esophageal dilation
2 FDA-approved medical therapies to treat EoE:
- Dupilumab (Dupixent) – a biologic agent approved for patients 1 year of age and older, with certain weight restrictions
- Eohilia – budesonide oral suspension for patients 11 years and older
Sometimes elemental nutrition may be recommended

8. Report “food getting stuck”—this is urgent

If food impaction occurs, seek immediate medical attention.

Senior-Specific Considerations

Older adults are at greater risk of malnutrition—avoid overly strict diets without guidance from your healthcare provider/dietician.
Dental issues can make chewing difficult; soft textures may help.
Appetite may be lower—small, nutrient-dense meals are helpful.

📌 When to Contact Your Healthcare Provider

Food is getting “stuck” or difficult to pass
Sudden worsening of swallowing
Significant unintentional weight loss
Symptoms do not improve with treatment
Concerns about nutrition or eliminating major food groups
Always ask your healthcare provider for specific advice on when to call to report symptoms, and when to seek urgent/emergency care.

Medical Disclaimer

The information provided in this resource is intended for general educational purposes only and should not be interpreted as medical or nutritional advice for any individual. Dietary recommendations, food choices, and nutrition strategies must be tailored to each person’s medical history, current health conditions, medications, allergies, and treatment plan. This material is not a substitute for professional medical advice, diagnosis, or treatment.

Patients should always consult their physician, registered dietitian, or other qualified healthcare provider before making any changes to their diet, fluid intake, or nutritional regimen, including the addition or removal of specific foods, beverages, supplements, or eating patterns. Never disregard professional medical advice or delay seeking care because of information presented in this resource.

This handout is for educational purposes only and is not a substitute for professional medical advice. Always follow your healthcare provider’s instructions.