Diagnosis

Your doctor will consider both your symptoms and test results to diagnose eosinophilic esophagitis. This will include determining whether you have gastroesophageal reflux disease (GERD).

Tests to diagnose eosinophilic esophagitis include:

• Upper endoscopy. Your doctor will use a long narrow tube (endoscope) containing a light and tiny camera and insert it through your mouth down the esophagus. The doctor will inspect the lining of your esophagus for inflammation and swelling, horizontal rings, vertical furrows, narrowing (strictures), and white spots. Some people with eosinophilic esophagitis will have an esophagus that looks normal.
• Biopsy. During an endoscopy, your doctor will perform a biopsy of your esophagus. A biopsy involves taking a small bit of tissue. Your doctor will likely take multiple samples from your esophagus and then examine the tissue under a microscope for eosinophils.
• Blood tests. If doctors suspect eosinophilic esophagitis, you may undergo some additional tests to confirm the diagnosis and to begin to look for the sources of your allergic reaction (allergens). You may be given blood tests to look for higher than normal eosinophil counts or total immunoglobulin E levels, suggesting an allergy.
• Esophageal sponge. This test is performed in the doctor's office and involves swallowing a capsule attached to a string. The capsule will dissolve in your stomach and release a sponge that the doctor will pull out your mouth with the string. As the sponge is pulled out, it will sample the esophageal tissues and allow the doctor to determine the degree of inflammation in your esophagus without having to undergo endoscopy.