Eosinophilic oesophagitis

EoE is an allergic condition of the oesophagus — increasingly common, frequently missed, and very treatable once it is actually diagnosed.

What EoE is

In eosinophilic oesophagitis, allergic inflammation — driven by immune cells called eosinophils — makes the oesophagus stiff and narrow over time. The classic story is a younger adult whose food sticks intermittently, who eats slowly, drinks plenty with meals, and avoids bread and meat without quite knowing why. Some patients first come to attention with a food bolus stuck completely — an emergency that should always trigger biopsies.

Diagnosis

EoE is diagnosed by gastroscopy with biopsies from multiple levels of the oesophagus — and the biopsies are the crucial part, because in a significant minority the oesophagus looks normal to the eye. Dr Zeki has a long‑standing clinical and research interest in EoE, including its dietary triggers, and takes systematic biopsies whenever the story suggests it.

Treatment

• Medical therapy — swallowed topical steroids formulated for the oesophagus, and proton‑pump inhibitors, both of which achieve remission in a substantial proportion of patients.
• Dietary therapy — structured elimination approaches for patients who prefer to treat the cause rather than take long‑term medication, planned with dietetic support rather than guesswork.
• Dilatation — gentle endoscopic stretching where narrowing has already developed.

EoE is a long‑term condition; the aim of treatment is lasting remission, confirmed where appropriate by follow‑up biopsies rather than assumed from symptoms alone.

Seeing Dr Zeki

Consultations take place on Tuesdays at HCA UK at The Shard, with testing and endoscopy at London Bridge Hospital — usually within days. Call 020 3301 4916 or email Dr Zeki's secretary to book. Fees and insurers.