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EoE or eosinophilic esophagitis is an uncommon form of allergic reaction to foods that occurs primarily in the esophagus and sometimes the stomach. Unlike the more familiar type of food allergies that develop within minutes, EoE develops so slowly that the offending foods are difficult to recognize. Immediate food allergic reactions, for example those caused by peanuts, result in swelling of the lips, tongue, face, and throat. Reactions may also be accompanied by hives, itching sneezing and nasal congestion. In a severe overdose, difficulty swallowing, breathing shock and even death can occur. EoE on the other hand is usually discovered incidentally during evaluation for other stomach complaints. The usual symptoms are nonspecific and related to dysfunction of the esophagus. Thus, most people will experience difficult to control heartburn, belching, bloating, nausea or food sticking in the esophagus. Difficulty swallowing is due to scarring and narrowing of untreated inflammation. This state of affairs is known as a stricture. It may cause regurgitation of undigested food, require liquids to assist passage of impacted food and may occur only with solid as opposed to liquid foods. Passage of an endoscope under light anesthesia is required to make the diagnosis. If examination of tissue from the esophagus under a microscope shows an increased number of eosinophils the diagnosis is confirmed. Eosinophils are a type of blood cell responsible for many of the symptoms of asthma and nasal allergies and are not normally present in the esophagus. Eosinophils cause damage to the esophagus. Current evidence suggests that food hypersensitivity attracts eosinophils into the esophagus. It has been found that switching to an elemental diet can reverse many of the findings in EoE. An elemental diet is one consisting of food that has been broken down or digested into a form that cannot trigger allergies. It is most often used in infants with food allergies. Determining which specific foods are responsible for EoE is discovered by food scratch tests or applying foods to the skin for 48 hours on a patch and examining the skin for an allergic reaction. If you have unexplained digestive issues, EoE is always a consideration.