Tests

People who have symptoms that may suggest eosinophilic oesophagitis (EoE) will usually be referred for an upper GI endoscopy. This is used to diagnose EoE and also looks for other causes of the same symptoms.

Upper GI endoscopy

The most common test for EoE symptoms is an upper GI endoscopy (also often referred to as an OGD). This is a common procedure involving the insertion of a thin tube with a camera on the end through the mouth into the oesophagus, stomach and first part of the small bowel called the duodenum. This test is important to look for signs of EoE as well as to look for other problems such as acid damage or oesophageal cancer. It is a very routine procedure, but as with any test there are benefits and risks, even though the risks are very low. More information on this procedure, its benefits and risks are available here.

To diagnose EoE, small samples of the gullet (called biopsies) need to be taken during the endoscopy. The tissue samples are very small, usually 2-3mm in size, and you will not be able to feel them being taken. These samples are sent away to be examined by a tissue expert under a microscope. In patients with EoE, this analysis shows an unusually high number of immune cells called eosinophils that give the condition its name.

Contrast swallow

This test may also be called a barium swallow and is often combined with a meal test to examine the stomach as well as the oesophagus. This is a useful test of how the oesophagus squeezes and to check that the stomach is lying in the normal place. It is not used to diagnose EoE, but may be used to look for other problems such as achalasia or a hiatus hernia. It involves drinking some fluid (called barium) and having x-ray pictures taken of the fluid going down the oesophagus into the stomach. X-rays are a form of ionising radiation. Doctors always minimise the amount of radiation to which patients are exposed. Your doctor will weigh the benefits and risks of having this test in making a decision to request this test for you.