DMV Allergy & Asthma Center – Allergist Washington DC, Frederick & Alexandria
Eosinophilic Esophagitis (EoE) Specialist in Alexandria, VA, Washington DC & Frederick, MD
Eosinophilic esophagitis is a rare, chronic immune-mediated condition that requires the expertise of a specialist to diagnose and manage accurately. At DMV Allergy & Asthma Center, our allergists and immunologists at Alexandria, VA, K Street, DC, Foxhall, DC, and Frederick, MD have extensive experience diagnosing and treating EoE across all age groups, from infants and children to adults, with personalized plans built around your specific triggers and disease severity.
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What is Eosinophilic Esophagitis (EoE)?
Eosinophilic esophagitis, commonly called EoE, is a chronic, immune-driven condition in which eosinophils (a type of white blood cell) accumulate in the esophagus, causing inflammation and progressive damage to the esophageal lining. It is closely linked to allergic disease and is often triggered by specific foods or environmental allergens. EoE affects people of all ages, though symptoms present very differently in infants, children, and adults, which is why specialist evaluation is essential for accurate diagnosis. At DMV Allergy & Asthma Center, our EoE specialists manage this condition as the allergic disease it fundamentally is, coordinating care with gastroenterology when needed.
EoE Symptoms by Age Group
EoE symptoms vary significantly depending on the patient’s age, making specialist evaluation critical for accurate diagnosis.
Infants & Toddlers:
- Feeding refusal and poor weight gain
- Vomiting and reflux that does not improve with antacid medication
Older Children:
- Vomiting, reflux, and reduced appetite
- Difficulty swallowing food
- Chest pain and abdominal pain
Adults:
- Difficulty swallowing solid food (dysphagia)
- Food getting stuck in the throat (food impaction)
- Persistent reflux, chest pain, and heartburn
Card Right — What Causes EoE?
EoE is driven by an immune response to food and/or environmental allergens. Common triggers include:
- Food allergens — milk, egg, soy, wheat, nuts, and fish are the most frequently implicated
- Environmental allergens — dust mites, pollen, mold, and animal dander
- Genetics — EoE can run in families and is associated with elevated expression of the eotaxin-3 gene
- Atopic background — EoE frequently co-occurs with asthma, allergic rhinitis, and eczema, pointing to a shared underlying immune mechanism
When Should You See an EoE Specialist?
EoE is a progressive condition, early diagnosis and treatment significantly improves long-term outcomes. See our specialists if:
Your child is experiencing feeding difficulties, poor growth, or reflux that is not responding to standard antacid treatment
You or your child has recurring difficulty swallowing, food impaction episodes, or unexplained chest pain after eating
A gastroenterology workup has raised the possibility of EoE and you need an allergist to evaluate the food or environmental allergen triggers involved
You have been diagnosed with EoE and need an allergy-focused specialist to help manage your triggers, dietary plan, and long-term treatment
How We Treat Eosinophilic Esophagitis
At DMV Allergy & Asthma Center, EoE treatment is built around identifying and addressing the allergic triggers driving esophageal inflammation, not just managing symptoms.
Comprehensive Evaluation
A detailed review of your symptom history, feeding patterns, food and environmental exposure, and prior testing, combined with allergy testing to identify the specific triggers driving your EoE.
Personalized EoE Treatment Plans
A targeted plan combining dietary management, medication, and trigger avoidance, developed by our EoE specialists and tailored to your age, symptom severity, and identified allergens.
Coordinated GI Care
For patients requiring endoscopic evaluation or biopsy confirmation, we work closely with gastroenterology specialists to ensure seamless, comprehensive care across both allergic and digestive aspects of EoE.
All Ages Welcome
From infants with feeding difficulties to adults with chronic dysphagia, our specialists provide age-appropriate EoE evaluation and management at every stage of life.
EoE Testing & Diagnosis
Diagnosing EoE requires identifying both the condition itself, confirmed by esophageal biopsy showing eosinophil accumulation, and the specific allergens triggering the immune response. Our allergy specialists focus on the allergy component to guide dietary and treatment decisions.
Allergy Skin Prick Testing
Used to identify environmental and food allergens that may be contributing to EoE. Results help guide targeted elimination diets and avoidance strategies, reducing the guesswork of broad food elimination.
Blood Testing & Allergen Panel
Measures allergen-specific IgE levels and total eosinophil counts to evaluate the immune-driven component of EoE, particularly valuable in young children or when skin testing is not suitable.
GI Referral for Endoscopy & Biopsy
Definitive EoE diagnosis requires endoscopic biopsy of the esophagus. When clinically indicated, we coordinate referrals to trusted gastroenterology specialists for this evaluation while managing the allergy component of the condition.
EoE Testing & Diagnosis
Quick, accurate results in about 20 minutes
EoE Treatment Options
We treat EoE with a combination of dietary management and medication, tailored to each patient's age, trigger profile, and disease severity.
Dietary Elimination Therapy
The 6-food elimination diet removes the most common EoE triggers, milk, egg, soy, wheat, nuts, and fish, to identify which foods are driving inflammation. Foods are reintroduced one by one to pinpoint specific culprits. For severe cases, an elemental diet using an amino acid formula may be recommended.
Proton Pump Inhibitors (PPIs)
PPIs are frequently used as part of EoE management to reduce acid exposure in the esophagus, which can contribute to symptoms and inflammation, particularly in patients with co-existing reflux.
Topical & Oral Steroid Therapy
Swallowed topical corticosteroids (such as fluticasone or budesonide) reduce esophageal inflammation directly. Oral steroids may be used for more severe or refractory cases under close medical supervision.
Biologic & Emerging Therapies
For patients with moderate-to-severe EoE or those who do not respond to dietary and steroid treatment, newer biologic therapies targeting the eosinophilic immune pathway are now available and offer significant promise for sustained disease control.
Why Choose DMV Allergy & Asthma Center?
For over 20 years, DMV Allergy & Asthma Center has helped patients across Virginia, DC, and Maryland get accurate diagnoses and effective treatment for complex allergic conditions including EoE.
4 convenient locations — Alexandria, VA, K Street, DC, Foxhall, DC, Frederick, MD
Board-certified allergists and immunologists experienced in diagnosing and managing EoE across all age groups
Coordinated EoE care — allergy evaluation, trigger identification, dietary management, and GI referral under one roof
Most insurance plans accepted
Trusted by 15,000+ patients across the DMV region, including Fairfax, Falls Church, Arlington, and beyond
Patient Satisfaction
98%
of patients recommend us
Real Results from Real Patients
J'adore le cabinet situé sur K Street ! Quelques mois après mon arrivée à Washington, j'ai développé de graves allergies. Le Dr Fishman et son équipe m'ont rapidement soulagée. Le personnel est incroyablement sympathique et arrangeant (ce qui est très appréciable vu la nature de mon travail). N'hésitez pas à venir ici pour tous vos problèmes d'allergies !
Le personnel est formidable. L'infirmière praticienne Casey est extrêmement compétente et rassurante, et mon infirmier Nick m'a beaucoup aidé. Le personnel de l'accueil était chaleureux et l'enregistrement s'est fait facilement.
Expérience formidable. Je recommande vivement. Une femme m'a particulièrement séduit. De loin la plus belle femme que j'aie jamais vue. 5 étoiles.
J'adore le cabinet situé sur K Street ! Quelques mois après mon arrivée à Washington, j'ai développé de graves allergies. Le Dr Fishman et son équipe m'ont rapidement soulagée. Le personnel est incroyablement sympathique et arrangeant (ce qui est très appréciable vu la nature de mon travail). N'hésitez pas à venir ici pour tous vos problèmes d'allergies !
Get Expert EoE Care Near You
Eosinophilic esophagitis is a complex condition, but with the right specialist, it is very manageable. Our EoE team at Alexandria, VA, K Street, DC, Foxhall, DC, and Frederick, MD is ready to identify your triggers, build a personalized plan, and coordinate every aspect of your care. Schedule your consultation today →
Frequently Asked Questions About Eosinophilic Esophagitis
We provide specialized EoE diagnosis and treatment for patients of all ages across the DMV region.
What does EoE stand for and what is it?
EoE stands for Eosinophilic Esophagitis, a chronic, immune-driven condition in which eosinophils build up in the esophageal lining, causing inflammation and damage. It is closely linked to allergic disease and triggered by specific foods or environmental allergens. EoE is distinct from acid reflux, though the two can co-exist, which is why specialist evaluation is essential for accurate diagnosis.
Who gets EoE and how common is it?
EoE affects both children and adults and is more common in males and individuals with a history of asthma, eczema, or allergic rhinitis. In children it often presents as feeding difficulties and poor growth; in adults, difficulty swallowing and food impaction are most common. Because symptoms vary so much by age, EoE is frequently underdiagnosed or mistaken for reflux.
How is EoE diagnosed?
Definitive diagnosis requires an upper endoscopy with biopsy, performed by a gastroenterologist, to confirm elevated eosinophil counts in esophageal tissue. The allergic triggers are evaluated by an allergy specialist using skin testing, blood allergen panels, and detailed food and environmental history. At DMV Allergy & Asthma Center, we manage the allergy component and coordinate with gastroenterology for the endoscopic workup when needed.
What foods cause EoE and how does the elimination diet work?
The most common food triggers are milk, egg, soy, wheat, nuts, and fish, the “Big Six.” The six-food elimination diet removes all six, then reintroduces them one by one while monitoring symptoms and repeating endoscopy to identify each patient’s specific culprits. This avoids permanently eliminating all six foods unnecessarily. For patients who cannot tolerate the elimination diet, an elemental amino acid formula diet may be recommended.
Is EoE related to asthma or other allergic conditions?
Yes, strongly. EoE is part of the atopic disease spectrum, and many patients also have asthma, allergic rhinitis, or eczema. Environmental allergens like pollen, dust mites, and mold can worsen EoE symptoms, which is why allergy specialist involvement is critical. Treating the allergic component often improves overall EoE control as part of a comprehensive plan.
Can EoE be cured or does it require lifelong management?
There is currently no cure for EoE; it is a chronic condition requiring ongoing management. However, with the right combination of dietary therapy, medication, and trigger avoidance, most patients achieve good symptom control and prevent progressive esophageal damage. The goal is to reduce eosinophilic inflammation, relieve symptoms, and prevent complications such as esophageal stricturing, all very achievable with consistent specialist-guided care.