If you think that your child may have eosinophilic esophagitis, contact your primary care physician. He or she may then refer you either to a pediatric gastroenterologist or allergist for further evaluation.
The only way to diagnose EoE is by a biopsy of the esophagus, performed by a gastroenterologist. The child is sedated and the physician inserts an endoscope into the mouth and through the esophagus, stomach and upper part of the small intestine, where a small sample of tissue is taken.
Sometimes, the gastroenterologist can see signs of EoE in the esophagus, such as "rings" or "white plaques." However, in many cases a child can have EoE and esophageal tissue that appears to be normal. Therefore, it is critical to obtain an esophageal biopsy sample.
Typical allergy tests, such as skin or blood tests that identify immediate allergic reactions, are not usually effective for diagnosis of eosinophilic esophagitis because the allergic reacting involved in EoE is often delayed several days after an allergen is introduced.
Skin patch test is often more insightful, but is not routinely offered by most allergists. Both tests are guidelines on how to introduce foods but like all tests nothing is 100 percent predictive.